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OCR
Minimum Medical Fee Schedule
for
Medical Treatment and
Care of Injured Employees
Established by the Industrial Commis-
sioner of the State of New York in
accordance with Chapters 258 and 930
of the Laws of 1935 amending the
Workmen's Compensation Law.
This Schedule applies to the
entire State of New York
Price 10 Cents
1
NEW YORK STATE
DEPARTMENT OF LABOR
FRIEDA S. MILLER, Industrial Commissioner
MICHAEL J. MURPHY, Deputy Commissioner
GODFREY P. SCHMIDT, Deputy Commissioner
ROSE SCHNEIDERMAN, Secretary
DIVISION OF WORKMEN'S COMPENSATION
Ralph R. Boyer, Director
Medical Registration Unit
Hugh J. Murphy, Registrar
INDUSTRIAL COUNCIL
Employee Representatives
John Halkett, Brooklyn
Thomas J. Curtis, New York City
Edward W. Edwards, Elmhurst, L. I.
James V. Barry, Woodside, L. I.
Anna M. Wolff, New York City
Employer Representatives
Maxwell S. Wheeler, Buffalo
Mark A. Daly, Buffalo
Charles M. Winchester, Albany
Max Meyer, New York City
Sylvan Stix, New York City
Physicians
W. D. Johnson, M.D., Batavia
E. C. Podvin, M.D., New York City
Horace E. Ayers, M.D., New York City
Albert W. Bailey, D.O., Schenectady
Henry Joachim, M.D., Brooklyn
4-10-40-20,000 (6-7718)
NOTICE
"§ 13. Treatment and care of injured employees. (a) The employer shall
promptly provide for an injured employee such medical, surgical or other
attendance or treatment, nurse and hospital service, medicine, crutches and
apparatus for such period as the nature of the injury or the process of
recovery may require. The employer shall be liable for the payment of the
expenses of medical, surgical or other attendance or treatment, nurse and
hospital service, medicine, crutches, and apparatus necessitated by the injury
of an employee, for such period as the nature of the injury or the process of
recovery may require. All fees and other charges for such treatment and
services shall be limited to such charges as prevail in the same community for
similar treatment of injured persons of a like standard of living.
"The Commissioner shall prepare and establish a schedule for the State, or
schedules limited to defined localities, of minimum charges and fees for such
medical treatment and care, to be determined in accordance with and to be
subject to change pursuant to rules promulgated by the Commissioner. Before
preparing such schedule for the State or schedules for limited localities the
Commissioner shall request the president of the Medical Society of the State
of New York to submit to him a report on the amount of remuneration deemed
by such society to be fair and adequate for the types of medical care to be
rendered under this Chapter, but consideration shall be given to the view of
other interested parties. The amounts payable by the employer for such
treatment and services shall in no case be less than the fees and charges
established by such schedule. Nothing in this schedule, however, shall prevent
voluntary payment of amounts higher than the fees and charges fixed therein,
but no physician rendering medical treatment or care may receive payment
in any higher amount unless such increased amount has been authorized by
the employer, or by decision as provided in Section 13-g herein." Chapter
258, Laws of 1935.
"Nothing in this section shall be construed as preventing the employment of
a duly authorized physician on a salary basis by an authorized compensation
medical bureau or laboratory." Chapter 930, Laws of 1935.
Following several hearings and conferences upon the subject, and upon the
recommendation of the Industrial Council, the following is hereby established
under the above provisions as the Minimum Fee Schedule for Medical Treat-
ment and Care of Injured Employees, to apply to the entire State of New
York, effective immediately.
FRIEDA S. MILLER,
Industrial Commissioner.
New York State
Department of Labor,
May 15, 1938.
[3]
MINIMUM MEDICAL FEE SCHEDULE
1. Section 13 (a) (Workmen's Compensation Law) requires that the employer
shall provide medical care for injured employees and that the Commis-
sioner shall establish and promulgate "a schedule for the State, or sched-
ules limited to defined localities, of minimum charges and fees for such
medical treatment and care"-etc. And further, "All fees and other
charges for such treatment and services shall be limited to such charges
as prevail in the same community for similar treatment of injured persons
of like standard of living."
2. This schedule to apply to the entire State of New York, effective immedi-
ately.
3. MINIMUM FEES. Section 13-d 2 (d), requires that the Commissioner
shall remove from the list of physicians authorized to render medical care
any one who "has rendered medical service under this Chapter for a fee
less than fixed by the Commissioner as the minimum rate in his locality."
Section 13 (a) says, "The amounts payable by the employer for such treat-
ment and services shall in no case be less than the fees and charges estab-
lished by such schedule."
4. Nothing in this schedule shall prevent voluntary payment of amounts
higher than the fees and charges fixed therein, but no physician rendering
medical treatment or care may receive payment in any higher amount
unless such increased amount has been authorized by the employer or by
decision as provided in Section 13-g herein.
5. Section 13-b 1 (g). Authorization of physician by Commissioner. "No
person shall render medical care under this Chapter without such author-
ization of the Commissioner"
etc.
EXCEPTIONS:
A. Any licensed physician may render emergency care.
B. Any member of a constituted hospital staff may render care while
the patient remains within the institution.
C. Technical assistants when under active personal direction of an
authorized physician.
D. Registered physiotherapists under written specific direction of
authorized physician.
6. NO CLAIM for medical or surgical treatment is valid or enforceable
unless
WITHIN 48 HOURS, (*) following first treatment, a preliminary report
(C-104) is filed; and
WITHIN 15 DAYS, (*) thereafter, a complete report (C-4) is filed.
Addendum A.
PROGRESS REPORTS
If the attending physician is requested in writing by the employer,
carrier, Industrial Board or Industrial Commissioner, he shall file a
progress report on a form to be provided, every three weeks (or at less
frequent intervals if SO requested).
EXCEPTIONS:
If patient is discharged from treatment within 48 hours after first
treatment, only a notarized C-4 report shall be filed marked "FINAL."
* Make triplicate record. Send one to your district office of the State Depart-
ment of Labor (see back of blanks). Send one to carrier, if known, or employer.
Keep one for your record.
[5]
7
6
7. EMERGENCY. Claim may need to be sustained by record of details that
15. PRORATION OF SCHEDULED UNIT FEE. When the schedule specifies
establish fact of emergency.
a unit fee for a definite treatment and period of after care, and the patient
is transferred from one to another physician, the employer (or carrier) is
8. PAYMENT OF MEDICAL FEES. Section 13-f. No physician shall
responsible for the amount stated in the schedule. If the concerned physi-
collect or receive a fee from the injured claimant. A hospital shall not
cians agree upon amount of proration they shall render separate bills
be entitled to remuneration paid to a physician on its staff.
accordingly; in the event of no agreement or disagreement, the matter
Section 13-f (1). "Fees for medical services shall be payable only to a
shall be settled by the Board of the local County Medical Society, or by
physician or other lawfully qualified person permitted by Section 13-b of
an arbitration committee appointed by it-without cost to the contestants.
this Chapter, or to the agent or to the executor or administrator of the
16. Presence of physician during examination by employer's (or carrier's)
estate of such physician."
physician, routine fee.
WRITTEN NOTICE OF CONTEST by the employer (or carrier) shall be
filed of the amount of the bill for medical care or hospital service within
17. Investigation and observation (without examination) by medical inspector
30 days after receipt of bill, or the right to an impartial examination of
acting for employer (or carrier) ; if presence of injured employee's physi-
the fairness of the amount claimed "shall be deemed to be waived and the
cian is required by carrier or employer the fee to the employee's physician
amount claimed by such physician or hospital shall be deemed to be the
shall be $4.00.
fair value of the services rendered by him or it."
18. Physician of "especially qualified" enrollment, who makes written opinion
or testimony, fee fixed by Commissioner, Section 13 (d).
9. DISAGREEMENT "as to value of medical aid rendered under this Chapter
shall be decided by an arbitration committee." Section 13-g (2).
19. PENALTY FEES. "When transfer of patient by employer (or carrier)
has not been authorized under this Section," Section 13-a (3) (2) : Same
9A. NO INSURANCE CASES. Sec. 13-g of Chapter 258 of the Laws of 1935
as total paid to other physicians or as determined by arbitration committee.
has been amended effective July 1, 1940 as follows:
20. Owners of plants requiring high frequency treatments may apply to the
(4) In claims where the employer has failed to secure compensation to
Industrial Commissioner for modification of the established fees in the
his employees as required by section fifty of this chapter, the board may
medical fee schedule. The Commissioner will cause an investigation to be
make an award for the value of medical services or treatment rendered
made in each instance and act upon the record when established. This
to such employees, in accordance with the schedule of fees and charges
privilege will be granted only on the assurance that it will not interfere
prepared and established under the provisions of section thirteen-a of
with the employee's right of free choice of physician.
this chapter. Such award shall be made to the physician or hospital
entitled thereto. A default in the payment of such award may be
21. In order to facilitate the prompt payment of medical bills, a discount of
enforced in the manner provided for the enforcement of compensation
5 per cent will be allowed on all medical bills in amounts of $15.00 or
awards as set forth in section twenty-six of this chapter.
over, if paid within 30 days, except on controverted cases when the 30-day
limit shall run from the date that a decision is rendered finding the
In all cases coming under this subdivision the payment of the claim of
claim compensible.
the physician or hospital for medical or surgical services or treatment
shall be subordinate to that of the claimant or his beneficiaries.
10. "A. AND A." means Authorization and Arrangement established by agree-
GENERAL MEDICO SURGICAL SERVICE
ment between the physician and the carrier or employer. This designation
has been applied where the extreme range of variation and complexity
Line
in the individual problem renders a fixed minimum standard impractical.
No.
Item
After-Care
Fee
49. First visit, home call, including reports
$4 00
11. CONCURRENT FEES for two or more physicians for an identical period
50. First office visit, including reports
3 00
of care and treatment will not be allowed except when warranted by com-
51. Office call
2 00
plication or noted need for assistance. When all the required care and
52. Home call - day
3 00
treatment reasonably falls within the range of qualifications of one physi-
53. Home call - night (if call received by doctor
cian no other shall claim a fee; only one physician shall be in charge of a
between 12 M to 7 A.M.)
5 00
case. Fees for assistants and consultants must be justified.
54. Hospital call
2 00
12. MULTIPLE INJURIES treated by one doctor requiring extensive surgical
55. Consultation with specialist, same fee as regular
visit.
dressings or care are to be charged for the greatest plus one-half of the
56. Salvarsan, plus cost of drug
5 00
lesser fees but limited to two times the greatest fee. Superficial injuries
57. Tetanus Antitoxin, add cost of drug to routine fee.
not requiring extensive attention are not to carry cumulative charges.
58. Assistant to surgeon
15 00
This Rule does not apply to multiple x-ray and pathological examinations.
(In hospital with interne staff no charge to
be made for service of interne or assistant.)
13. EXTENSIVE AND UNUSUAL DRESSINGS. When a patient requires
unusual, extensive and extraordinary dressings, the cost of material
59. Strapping of joints.
64. Strapping of shoulder, routine service 1ee plus
1 00
(enumerated and noted in bill) may be added to schedule of fee for service.
65. Strapping of hip, routine service fee plus
1 00
14. UNIT FEES. When the schedule specifies a fee for a service and a period
66. Strapping of sacro-lumbar spine, routine service fee
plus
1 00
of after care, and for any reason there is a transfer of the care and treat-
67. Strapping of thorax. routine service fee plus
1 00
ment to a second or other physician, the stated amount in the schedule
shall cover the combined fee of all.
(For fracture of ribs, see Line 164)
8
9
Line
Line
No.
Item
After-Care
Fee
No.
Item
After-Care
Fee
X-RAY DEMONSTRATION OF INJURED PARTS
130. Gas each additional one-half hour
5 00
131. Ether up to one-half hour
5 00
80. Lines Nos. 83 to 102 inclusive represent
132. Ether each additional one-half hour
5 00
scope and fees for physicians with the
133. Chloroform up to one-half hour
5 00
" X qualification.
134. Chloroform each additional one-half hour
5 00
81. Such x-ray demonstration of injured parts
135. Spinal for first hour
15 00
is limited to those patients who are under
136. Spinal over one hour
20 00
his general medical care.
137. Rectal, when performed by other than operator
15 00
83. Fees are for regional examination, size
138. Rectal over one hour
20 00
and number of films not relevant.
139. Intravenous anaesthetic to one-half hour
10 00
84. Teeth, complete dental study
5 00
140. Intravenous anaesthetic to one hour
15 00
85. Single finger
2 50
141. Intravenous anaesthetic over one hour
20 00
86. Single toe
2 50
142. Local anaesthesia by operator is part of
87. Hand (including fingers)
4 00
operating fee, as scheduled.
88. Wrist (including carpus and lower 1/3 forearm)
4 00
89. Forearm mid one-third
4 00
FRACTURES
90. Elbow (including upper one-third of forearm and
4 00
150. Compound fractures - increase fee 50%.
supracondyles)
151. Skull operative, not within dura
3 wks.
100 00
91. Humerus mid one-third
4 00
152. Skull involving work within dura
3 wks.
150 00
92. Foot (including toes)
4 00
93. Ankle (including lower three inches of leg)
4 00
153. Skull non-operative, on a per visit basis.
94. Leg mid one-third
154. Maxilla, closed
3 wks.
35 00
4 00
155. Mandible (uncomplicated) unilateral
3 wks.
50 00
95. Knee (including four inches above and below joint)
4 00
96. Femur mid one-third
4 00
156. Mandible (uncomplicated) bilateral
3 wks.
100 00
157. Malar
3 wks.
35 00
97. Femur upper one-third
4 00
98. Shoulder joint
5 00
158. Nose
3 wks.
25 00
99. Clavicle
5 00
159. Nasal septum
A. & A.
160. Trephine
3 wks.
100 00
100. Scapula
5 00
101. Hip joint
7 50
161. Clavicle, closed
3 wks.
40 00
102. Nasal bones
162. Clavicle, open
A. & A.
5 00
163. Scapula
3 wks.
40 00
164. Ribs, strapping of
5 00
165. Vertebrae, contiguous, bodies or laminae, closed
2 mos.
100 00
103. Physical therapy, inclusive of any and all modalities.
2 00
166. Vertebral processes, non-operative
10 00
104. Electrocardiogram
10 00
167. Vertebrae, open
A. & A.
105. Allergy test
A.&A.
168. Humerus, closed
2 mos.
100 00
106. Immunology
A.&A.
169. Humerus, open
2 mos.
150 00
107. Spinal puncture
10 00
170. Radius or ulna, closed
2 mos.
50 00
108. Spinal puncture with manometric determination
15 00
171. Radius or ulna, open
2 mos.
75 00
109. Blood transfusion, direct
50 00
172. Radius and ulna, closed - shaft
2 mos.
100 00
110. Blood transfusion, indirect (citrate)
25 00
173. Radius and ulna, open - shaft
2 mos.
150 00
111. Fee for donor, Regular Blood Donors'
174. Colles fracture, closed
2 mos.
65 00
Association fee.
175. Colles fracture, open
2 mos.
110 00
112. Gastric lavage (poison, etc.)
10 00
176. Elbow (including humerus, radius and ulna), closed.
2 mos.
75 00
113. Burns, according to area involved and per visit
A. & A.
177. Elbow (including humerus, radius and ulna), open
2 mos.
110 00
114. Skin patch test
A. & A.
178. Carpal bones, closed
2 mos.
50 00
115. Abdominal paracentesis
10 00
179. Carpal bones, open
2 mos.
100 00
116. Uterine Curettage, 3 weeks after care
50 00
180. Metacarpals (one or more), closed
3 wks.
30 00
117. Injection, veno surgery
5 00
181. Metacarpals (one or more), open
2 mos.
75 00
182. Finger - one
3 wks.
20 00
ANAESTHESIA
183. Fingers, multiple on one hand
3 wks.
35 00
125. When given by other than operating sur-
184. Femur, closed
2 mos.
150 00
geon. Period of time to be measured
185. Femur, open
2 mos.
175 00
from beginning of induction of anaes-
186. Patella, closed
3 wks.
50 00
thesia to recorded end of operation.
187. Patella, open
6 wks.
100 00
126. Anaesthesia, given by a medical anaesthetist speci-
188. Tibia, closed
2 mos.
75 00
fically called, an additional fee of
5 00
189. Tibia, open
2 mos.
110 00
127. Gas, first one-fourth hour
5 00
190. Fibula, closed
2 mos.
50 00
128. Gas up to one-half hour
10 00
191. Fibula, open
2 mos.
75 00
129. Gas up to one hour
15 00
192. Tibia and fibula, closed
2 mos.
100 00
10
11
Line
Line
No.
Item
No.
Item
After-Care
Fee
After-Care
Fee
193. Tibia and fibula, open
2 mos.
150 00
AMPUTATIONS
194. Potts fracture, closed
2 mos.
75 00
275. Arm, disarticulation, uncomplicated
6 wks.
150
00
195. Potts fracture, open
2 mos.
110 00
276. Arm, thru head or neck
6 wks.
100
00
196. Metatarsal bones, closed
3 wks.
30 00
277. Arm, below neck
6 wks.
75 00
197. Metatarsal bones, open
2 mos.
75 00
278. Forearm
6 wks.
75 00
198. Toes - single toe - first toe
3 wks.
20 00
279. Hand at wrist
6 wks.
75 00
199. Toes — single toe - other than first
3 wks.
15 00
280. Carpus
6 wks.
60 00
200. Toes - multiple on same foot
3 wks.
25 00
281. Metacarpus
6 wks.
50 00
201. Sacrum, closed
3 wks.
50 00
282. Phalanx
6 wks.
30 00
202. Pelvis, one bone
3 wks.
50 00
283. Thigh, disarticulation
6 wks.
150 00
203. Pelvis, multiple
3 wks.
75 00
284. Leg at knee
6 wks.
100 00
204. Pelvis, open
A. & A.
285. Patella, excision
6 wks.
75 00
205. OsCalcis, closed
2 mos.
50 00
286. Femur, head and neck
6 wks.
150 00
206. OsCalcis, open
2 mos.
100 00
287. Femur
6 wks.
100 00
207. Astragalus, closed
2 mos.
40 00
288. Knee
6 wks.
100 00
208. Astragalus, open
2 mos.
80 00
289. Tibia or fibula
6 wks.
100 00
209. Tarsal bones, others, closed
2 mos.
30 00
290. Foot at ankle joint
6 wks.
75 CO
210. Tarsal bones, others, open
2 mos.
60 00
291. Foot thru metatarsus
6 wks.
75 00
211. Multiple fractures, not in same hand or
292. OsCalcis (Syme's amp.)
6 wks.
100 00
foot: Add to the greater fee a sum equal
293. Phalanx (toe)
6 wks.
30 00
to 50 per cent of each lesser, not exceed-
294. Astragalectomy
2 mos.
100 00
ing two times the greater.
295. Laminectomy or other osteoplastic
2 mos.
200 00
12.
Multiple injuries treated by one doctor, requiring extensive
296. Coccyx, removal
3 wks.
50 00
surgical dressings or care, are to be charged for the
297. Spinal fusion, involving bone inlay
2 mos.
200 00
greatest plus one-half of the lesser fees but limited to
298. Removal of semi-lunar cartilage
2 mos.
100 00
two times the greatest fee. Superficial injuries not
299. Rib excision or resection
3 wks.
50 CO
requiring extensive attention are not to carry cumulative
charges. This Rule does not apply to multiple x-ray
300. Arthrodesis hip
2 mos.
150 00
or pathological examinations.
301. Arthrodesis wrist
2 mos.
100 00
15.
Proration of scheduled unit fee: When the schedule
302. Arthrodesis knee
2 mos.
100 00
specifies a unit fee for a definite treatment and period
of after-care, and the patient is transferred from one to
303. Arthrodesis shoulder
2 mos.
100 00
another physician, the employer (or carrier) is respon-
304. Bone graft for non-union of femur including post-
sible for the amount stated in the schedule. If the con-
operative therapy
4 mos.
200 00
cerned physicians agree upon amount of proration they
shall render separate bills accordingly; in the event of
305 Bone graft for non-union of tibia, including post-
no agreement or disagreement, the matter shall be settled
operative therapy
4 mos.
175 00
by the Board of the local County Medical Society of the
306. Bone graft humerus, including post-operative
first attending physician, or by an arbitration com-
mittee appointed by without cost to the contestants.
therapy
4 mos.
175 00
22.
If in the course of treatment consultation is necessary,
307. Bone graft - forearm, including post-operative
authorization in accordance with Section 13-A-5 should
therapy
4 mos.
175 00
be obtained except in emergency.
SURGICAL PROCEDURES
DISLOCATIONS
INCISION
250. Tempero-mandibular
10 00
251. Spine, open
6 mos.
150 00
325. Incision for superficial abscess as furuncle or boil
3 00
252. Spine, closed
2 mos.
100 00
326. Incision for abscess, carbuncle with multiple pockets.
5 00
327. Incision of deep abscess or infection
25 00
253. Shoulder
3 wks.
40 00
254. Shoulder, recurrent — operation
A. & A.
328. Paronychia
5 00
3 wks.
35 00
329. Laparotomy, exploratory only
3 wks.
100 00
255. Elbow, closed
256. Elbow, open
3 wks.
75 00
330. Operation on viscera
A. & A.
331. Simple bowel resection
3
257. Finger, reduction and splint
5 00
wks.
150 00
258. Finger, open
3 wks.
40 00
332. Encephalogram
A. & A.
259. Hip
3 wks.
75:00
333. Osteomyelitis
A. & A.
260. Knee
3 wks.
60 00
EXCISION
261. Ankle
3 wks.
40 00
262. Astragalus, closed
3 wks.
50 00
350. Removal of nail, finger or toe, including local
263. Astragalus, open
2 mos.
100 00
anaesthetic
5 00
264. OsCalcis, closed
3 wks.
50 00
351. Excision of sub-deltoid bursa
3 wks.
50 00
265. OsCalcis, open
2 mos.
100 00
352. Excision of pre-patellar bursa
3 wks.
35 00
266. Toe, reduction and splint
5 00
353. Pilonidal cyst
A. & A.
267. Wrist closed
3 wks.
35 00
354. Ganglion by excision
3 wks.
35 00
13
12
Line
Line
After-Care
Fee
No.
Item
After-Care
Fee
No.
Item
REPAIR
" SB " QUALIFICATION
365. Tendon, one primary
35 00
425. Orthopedist, complete office examination or con-
3 wks.
10 00
sultation
366. Tendon, each additional
$10 00, maximum 100 00
426. Orthopedist, check-up" examination of referred
367. Tendon, secondary
A. & A.
5 00
370. Nerve suturing, primary, single
3 wks.
35 00
patient
427. Orthopedist, subsequent examination or care not
371. Nerve suturing, each additional
$10 00, maximum
100 00
included in scheduled " after care"
3 00
372. Nerve suturing, secondary
A. & A.
375. Hernia, single (including assistant's fee)
8 wks.
75 00
376. Hernia, double (including assistant's fee)
8 wks. 100 00
" SA " QUALIFICATION
377. Hernia, recurrent
A. & A.
A. & A.
430. Surgeon, complete office examination or consulta-
378. Hernia by injection
10 00
tion
379. Hernia, diaphragmatic
A. & A.
431. Surgeon, "check-up" examination of referred
380. Hernia, post-surgical (including assistant's fee)
8 wks.
100 00
5 00
381. Hernia, ventral (including assistant's fee)
8 wks. 100 00
432. Surgeon, patient subsequent examination or care not in-
382. Hernia, strangulated.
A. & A.
2 00
cluded in scheduled after care
385. Suture of soft tissue wound, such as -
386. Skin: Routine fee plus $1.00 for each suture
maximum
10 00
387. Fascia: Routine fee plus $1.00 for each suture
maximum
10 00
" SC " QUALIFICATION
388. Muscle: Routine fee plus $1.00 for each suture
maximum
10 00
438. Surgeon, first care, if not otherwise scheduled
3 00
390. Superficial lacerations: Office Visit.
439. Surgeon, subsequent office visits or hospital visit
2 00
440. Surgeon, patient's home or place of employment.
3 00
FOREIGN BODIES
Day
441. Surgeon, patient's home or place of employment.
392. Foreign body extraction, intracutaneous;
Night, 12 Midnight to 7 A. M
5 00
office fees.
393. Foreign body extraction, subcutaneous, without
anaesthetic
5 00
EAR, NOSE AND THROAT
394. Foreign body extraction, subcutaneous, with
" SF QUALIFICATION
anaesthetic
10 00
395. Foreign body extraction, deep
3 wks.
25 00
450. Nose, complete office examination or consulta-
10 00
396. Note: Above extractions do not include
tion and report
removal of foreign body from eye or orbit.
451. Nose, subsequent office examination or consulta-
5 00
tion
452. Nose, extensive study, various charges according
A. & A.
CONSULTATIONS AND CONSULTANT CARE
to special tests
3 wks.
25 00
453. Nasal bones, fracture
" SG " QUALIFICATION
454. Submucuous resection of nasal septum
2 wks.
75 00
455. Otoscopic examination, including functional test of
10 00
400. Urologist office consultation fee, complete, but not
cochlea
inclusive of cystoscopy or x-ray demonstration
15 00
456. Ear examination, including functional tests of
A. & A.
401. Urologist, subsequent office or hospital visits, ex-
cochlea and labyrinth
clusive of " after care as specified
3 00
457. Direct laryngoscopy; instrumentation with laryn-
goscope (inclusive of removal of foreign body or
25 00
biopsy)
" SI " QUALIFICATION
458. Direct laryngoscopy, removal of growth
1 wk.
50 00
1 wk.
50 00
410. Neurologist or psychiatrist, complete office exami-
459. Bronchoscopy
460. Bronchoscopy, with removal of biopsy
50 00
nation or consultation
20 00
461. Bronchoscopy, with foreign body extraction
75 00
411. Neurologist or psychiatrist, for subsequent office
50 00
diagnostic consultation
5 00
462. Oesophagoscopy
50 00
412. Neurologist or psychiatrist, for other subsequent
463. Oesophagoscopy, with removal of biopsy
3 00
464. Oesophagoscopy, with foreign body extraction
75 00
office visits
1 wk.
40 00
465. Tonsillectomy
3 days
75 00
466. Tracheotomy
3 wks.
100 00
" SJ " QUALIFICATION
467. Mastoid - simple*
468. Mastoid - radical*
3 wks.
150 00
420. Internist, complete office examination or consulta-
tation
10 00
* RADICAL MASTOID - fee allowed only when mastoid and middle ear cavities are made
421. Internist, subsequent office visits
3 00
one bony wall removed.
14
15
Line
Line
No.
Item
After-Care
Fee
No.
Item
After-Care
Fee
469. Mastoid - bilateral
3 wks.
225 00
602. Fixation of kidney
A. & A.
471. Antrotomy puncture with irrigation
10 00
603. Kidney calculi-removal
3 wks.
150 00
472. Antrotomy - window
3 wks.
50 00
604. Nephrotomy
3 wks.
100 00
473. Antrotomy - radical
A. & A.
605. Cystotomy
3 wks.
75 00
474. Antrotomy - subsequent irrigations
5 00
606. Cystoscopy without X-ray
25 00
475. Epistaxis, arrest of bleeding, office visit.
607. Cystoscopy including catherization ureters
35 00
476. Epistaxis, with electrocoagulation or electro-
608. External Urethrotomy
A. & A.
cauterization
10 00
609. Hydrocele - radical
3 wks.
50 00
477. Epistaxis, without electrocoagulation, office visit.
610. Hydrocele- - tapping
10 00
478. Myringotomy, in office (puncture)
5.00
611. Orchidectomy
3 wks.
60 00
479. Nyringotomy, at hospital or home or other place
10 00
612. Epididymectomy
3 wks.
75 00
480. Subsequent office visits
3 00
(Lines 601 to 612 apply to all qualified surgeons
481. House visit, routine, for examination and opinion
5 00
with " A rating or equivalent.)
482. Hospital visit, for ordinary visit, dressings and
observation
3 00
DERMATOLOGY
EYE
" SH " QUALIFICATION
"
SE " QUALIFICATION
650. Complete office examination or consultation
10 00
525. Simple, office, eye check-up on referred patients,
650a. Check-up office examination of referred patient
5 00
mere observation (no refraction, no study of
651. Subsequent office examination or care
3 00
retina)
5 00
652. Subsequent care, with X-ray therapy
5 00
526. Compiete office examination or consultation without
653. Hospital visit
3 00
refraction
10 00
654. Neo-salvarsan, plus cost of drug
7 50
527. Special study, special test for permanent disability
and report.
A. & A.
528. Refraction alone and prescription for glasses
7 50
PROCTOLOGY
529. Combined full examination (526 and 528) and re-
fraction and prescription for glasses
12 50
530. Subsequent office visit
3 00
" SM8 " QUALIFICATION
531. Hospital visits
3 00
535. Foreign body embedded in cornea, removal of
5 00
664. Complete office examination or consultation
10 00
536. Removal of intra-ocular foreign body
21 days
100 00
665. Anal fissure, divulsion under anaesthesia
15 00
537. Removal of intra-orbital foreign body
21 days
100 00
666. Single fistula including 3 weeks after care
50 00
560. Primary suture of lid wounds
15 00
667. Multiple fistulae including 3 weeks after care
75 00
561. Iridectomy
10 days
60 00
668. Hemorrhoids, removal by injection, per visit
5 00
562. Cataract extraction
10 days
100 00
669. Hemorrhoids, external, single, 2 weeks after care
25 00
563. Muscle operation
A. & A.
670. Hemorrhoids, multiple external, 2 weeks after care
50 00
564. Plastic lid operation
A. & A.
671. Hemorrhoids, internal, 2 weeks after care
50 00
568. Discission (needling) of cataract
10 days
75 00
672. Incision of thrombosed hemorrhoid
10 00
569. Operation for detachment of retina
10 days
100 00
673. Prolapse, anal, treatment by laparotomy including
570. Enucleation of eyeball
21 days
100 00
3 weeks after care
150 00
571. Evisceration of eyeball
21 days
100 00
674. Rectal resection, including 4 weeks after care
150 00
572. Conjunctivokeratoplasty for perforating wounds of
(Lines 66.4 to 674 apply to all qualified surgeons
eyeball
A. & A.
with " A " rating or equivalent.)
575. Glaucoma operation
10 days
100 00
576 Operation for strabismus
A. & A.
577. Dacryocystectomy
10 days
75 00
PHYSICAL THERAPY
578. Chalazion operation, either dissection or incision and
currettage
15 00
" SM1 " QUALIFICATION
UROLOGY
690. Per visit, inclusive of any and all modalities
3 00
(When total fees for physical therapy treatment
" SG " QUALIFICATION
approach the sum of $25.00, the physician
should file an additional C-4 report and re-
600. Neo-salvarsan plus cost of drug
7 50
quest authorization as prescribed in Section
601. Excision of kidney
3 wks.
150 00
13-A-5.)
16
17
OSTEOPATHY
Line
No.
Item
Line
After-Care
Fee
No.
Item
After-Care
Fee
URINE
" OP " QUALIFICATIONS
740. Routine chemical qualitative without micro-
scopic
Lines Nos. 691 to 695 apply only when
1 00
osteopathic manipulation is included.
741. Routine - chemical qualitative with microscopic
2 00
691. Examination or consultation at office - - first visit
4 00
742. Routine — chemical and microscopic including
quantitative sugar
692. Subsequent office visits
3 00
3 00
4 00
743. Arsenic or lead (heavy metals)
693. Home call - day
A. & A.
744. Quantitative urea
694. Home call - night (between 12 midnight and
2 00
745. Quantitative creatinine
7 a.m.)
5 00
2 00
746. Quantitative uric acid
695. Hospital call
3 00
2 00
747. Quantitative ammonia
696. As respects all other items in this schedule
2 00
748. Quantitative chlorides
which come lawfully within the scope of
2 00
749. Quantitative total nitrogen
osteopathy, osteopaths shall be entitled
2 00
750. Above five tests
to the same fees as permitted for physi-
10 00
751. Phthalein
cians practising in other fields of
2 00
752. Urobilin quantitative
medicine.
3 00
753. Tyrosin
3 00
754. Mosenthal or other conc. tests
5 00
PATHOLOGY
755. Simple culture
5 00
756. Special culture
BLOOD
A. & A.
757. Ureter specimens, urea, microscopic plus cultures,
both sides
700. Wassermann
5 00
15 00
758. Tuberculosis - extra
701. Wassermann - any modifications
5 00
3 00
759. Animal Inoculation
702. Precipitation (Kabn or other precipitation test)
3 00
10 00
703. Any two tests of the above
7 50
704. Complement fixation gonococcus
3 00
CEREBROSPINAL FLUID
705. Full blood count
5 00
765. Wassermann
706. White blood count and differential
2 00
5 00
766. Precipitation
707. Coagulation time
2 00
3 00
767. Colloidal Gold Test
708. Sedimentation test
3 00
3 00
768. Cell Count
709. Fragility test
3 00
2 00
769. Globulin
710. Platelet count
2 00
2 00
770. Simple culture
711. Full test hemorrhagic diathesia
10 00
5 00
2 00
771. Special culture
712. Icteric index
A. & A.
772. Smear for Bacteria
713. Special culture
A. & A.
2 00
773. Tubercle Bacilli
714. Widal
3 00
3 00
774. Twelve hour sedimentation test
715. Simple culture
5 00
5 00
716. Bilirubin VandenBergh
3 00
775. Full spinal fluid examination for syphilis (Wasser-
717. Malaria (plus red blood count)
2 00
mann-Colloidal Gold-Cells-Globulin)
7 50
776. Animal inoculation
718. Typing and grouping
5 00
10 00
777. Tissue examination
719. Cross agglutination tests
5 00
A. & A.
720. Additional per person
2 00
721. Urea nitrogen
2 00
FROZEN SECTION
722. Non-protein nitrogen
2 00
723. Uric acid
3 00
781. Frozen section, in hospital (pathologist at operation).
15 00
724. Cholesterin
3 00
782. Frozen section, outside
A. & A.
725. Creatinine
3 00
726. Sugar
2 00
MISCELLANEOUS ITEMS
727. Co2
2 00
790. Throat culture
3 00
728. Any four tests of the above
7 50
791. Smears - all except otherwise stated
729. Calcium
3 00
2 00
792. Search for bacilli in exudates
730. Magnesium
3 00
3 00
793. Sputum for tubercle bacilli
3 00
3 00
731. Phosphorus
794. Simple sputum culture
732. Chlorides
3 00
5 00
795. Special sputum culture
A. & A
733. Any three of the above
7 50
796. Sputum microscopic
3 00
2 00
734. Lactic acid
797. Vaccines sputum
3 00
7 50
735. Hydrogen ion concentration
798. Typing of pneumococcus
5 00
736. Albumin-gobulin ratio
7 50
799. Dark field no charge for smear, venereal, etc
5 00
18
19
Line
Line
No.
Item
After-Care
Fee
No.
Item
After-Care
Fee
800. Stomach contents for ferments
5 00
801. Ewald or retention
5 00
852. Fees are for a competent diagnosis by x-ray
802. Fractional Rehfus
5 00
image, expert interpretation and opinion
803. Bacteriophags
A. & A.
- size and number of films not relevant.
804. Calculi
A. & A.
853. Single finger
5 00
854. Single toe
5 00
855. Hand (including fingers)
8 00
FECES
856. Wrist (including carpus and lower one-third of
810. Parasites
3 00
forearm)
8 00
5 00
857. Forearm mid one-third
811. Typhoid and para cultures
8 00
812. Microscopic for bacteria, etc
3 00
858. Elbow (including upper one-third of forearm and
813. Urobilin
3 00
supracondyles)
8 00
859. Humerus mid one-third
814. Urobilin quantitative
5 00
8 00
815. Histamine
3 00
860. Foot (including toes)
8 00
816. Occult blood only
2 00
861. Ankle (including lower three inches of leg)
8 00
817. Ferments
5 00
862. Leg, mid one-third
8 00
818. Simple culture
5 00
863. Knee (including four inches above and below joint)
8 00
A. & A.
864. Femur mid one-third
819. Special culure
8 00
820. Fats - quantitative
5 00
865. Femur upper one-third
8 00
870. Shoulder joint
10 00
871. Clavicle
10 00
SPECIAL PROCEDURES
872. Scapula
10 00
821. Basal metabolism
10 00
873. Hip joint
15 00
822. Immunology and allergy
A. & A.
875. Head and face, complete examination
20 00
823. Spinal puncture
10 00
876. Head and face, partial examination for follow-up
824. Spinal puncture with manometric determination
15 00
when area of injury has been demonstrated
previously
10 00
830. Complete post mortem and report, without micro-
scopic work
50 00
880. Nasal bones
10 00
881. Nasal sinuses
831. Complete post mortem and report, with tissue micro-
15 00
scopic examination
75 00
882. Mastoids
15 00
883. Mandible- - one side
10 00
832. Other post mortem laboratory work, as
884. Cervical spine
15 00
scheduled above.
885. Dorsal spine
15 00
835. When pathologist visits patienťs home
886. Lumbar spine
15 00
or other place to obtain specimen, add
887. Pelvis
15 00
$3.00 for home visit to the above items.
888. Sacro-iliac joint and coccyx
15 00
836. The attending physician will not make
889. Any two spinal regions
25 00
charge for obtaining specimen, except
890. Any three spinal regions
35 00
spinal puncture.
891. Sacro-iliac (including lumbo-sacral facets)
A. & A.
900. Thoracic cage (not including spine) any one area
15 00
ROENTGENOLOGY AND RADIOLOGY
901. Lungs and heart (not including cardiac mensura-
tion)
15 00
"
902. Cardiac mensuration (including fluoroscopy)
15 00
SD
" QUALIFICATION
903. Abdomen and gastrointestinal; flat plate for acute
850. Lines 850 to 945 inclusive specify fees for
obstruction
15 00
physicians who are qualified as " SD.
904. Oesophagus only (including fluoroscopy)
15 00
851. (Instructions: Do not file either C-104
905. Gastro-intestinal (oesophagus to cecum)
25 00
or C-4 reports. Instead, make writ-
906. Gastro-intestinal (oesophagus to ampulla)
35 00
ten report in quadruplicate; having one
907. Colon by opaque enema
20 00
notarized and sent to the district office
908. Gall bladder, simple
15 00
of the State Department of Labor; send
909. Gall bladder, Graham test, oral
25 00
one to the attending physician or sur-
909a. Intravenous or Stewart Concentrate
35 00
geon; retain one for record. Render
910. Genito-urinary- - simple
15 00
separate bill to carrier, if known, or
911. Genito-urinary - retrograde pylography (not in-
employer with the report. Films shall be
clusive of injection)
15 00
preserved by roentgenologist and they
912. Genito-urinary - pylography by excretion
25 00
(or satisfactory prints) shall be made
913. Teeth - complete dental study
10 00
available to attending physician, carrier
914. Foreign body; same as part involved
or employer.)
915. Foreign body - search of respiratory or alimentary
canal
20 00
20
21
Line
Line
No.
Item
After-Care
Fee
No.
Item
After-Care
Fee
916. Foreign body - eye, precise localization
25 00
1101. Lungs and heart (not including cardiac mensura-
917. Foreign body - eye, without precise localization
15 00
tion)
7 50
918. Bedside - institutional - add 15% to normal fee
1102. Cardiac mensuration, including fluoroscopy
7 50
for part
1103. Abdomen and gastrointestinal; flat plate for acute
919. Bedside - domicile
A. & A.
obstruction
7 50
920. Interpretation of films made elsewhere
A. & A.
1105. Gastro-intestinal (oesophagus to cecum)
12 50
935. Radium therapy
A. & A.
1106. Gastro-intestinal (oesophagus to ampulla)
17 50
940. X-ray therapy
A. & A.
1108. Gall bladder, simple
7 50
945. When patients are treated by x-ray or
1110. Genito-urinary, simple
7 50
radium C-104 and C-4 must be filed.
1111. Genito-urinary, retrograde pylography (not inclusive
of injection)
7 50
1113. Foreign body, same fees as No. 1053 to 1075
X-RAY DEMONSTRATION BY SPECIALISTS OTHER THAN
according to region.
THOSE HAVING " SD " QUALIFICATION
1114. Foreign body, search of respiratory or alimentary
canal
10 00
1050. Lines 1050 to 1150 inclusive apply to special-
1116. Foreign body - eye, precise localization
12 50
ists other than those having S.D."
1118. Bedside, domicile
A. & A.
qualifications; each specialist limited to
1119. Colon by opaque enema
8 00
his own special field, but shall not be
(Lines 1120-1150 are blank.)
barred from examining patients referred
for x-ray examination only in his own
special field.
X-RAY DEMONSTRATION BY PHYSICIANS WITH " XD "
1051. Teeth - Complete dental study
5 00
QUALIFICATION
1053. Single finger
2 50
1054. Single toe
2 50
1200. Lines Nos. 1200 to 1300 inclusive apply to
1055. Hand (including fingers)
4 00
physicians with the " X.D." qualifica-
1056. Wrist (including carpus and lower one-third of
cation. Nothing in this schedule shall
forearm)
4 00
bar such physicians from examining
1057. Forearm, mid one-third
4 00
patients referred for x-ray examination
1058. Elbow (including upper one-third of forearm and
only as respects to lines 1200 to 1300.
supracondyles)
4 00
1201. Fees are for regional examination, size and
1059. Humerus, mid one-third
4 00
number of films not relevant
1060. Foot (including toes)
4 00
1202. Single finger
3 50
1061. Ankle (including lower three inches of leg)
4 00
1203. Single toe
3 50
1062. Leg, mid one-third
4 00
1204. Hand (including fingers)
6 00
1063. Knee (including four inches above and below joint)
4 00
1205. Wrist (including carpus and lower one-third fore-
1064. Femur, mid one-third
4 00
arm)
6 00
1065. Femur, upper one-third
4 00
1206. Forearm mid one-third
6 00
1070. Shoulder joint
5 00
1207. Elbow (including upper one-third of forearm and
1071. Clavicle
5 00
supracondylos)
6 00
1072. Scapula
5 00
1208. Humerus mid one-third
6 00
1073. Hip joint
7 50
1209. Foot (including toes)
6 00
1075. Head and face, complete examination
10 00
1210. Ankle (including lower three inches of leg)
6 00
1076. Head and face, partial examination for follow-up
1211. Leg mid one-third
6 00
when area of injury has been demonstrated pre-
1212. Knee (including four inches above and below joint)
6 00
viously
5 00
1213. Femur mid one-third
6 00
1080. Nasal bones
5 00
1214. Femur upper one-third
6 00
1081. Nasal sinuses
7 50
1215. Shoulder joint
8 00
1082. Mastoids
7 50
1216. Clavicle
8 00
1083. Mandible, one side
5 00
1217. Scapula
8 00
1084. Cervical spine
7 50
1218. Hip joint
11 00
1085. Dorsal spine
7 50
1219. Head and face, complete examination
15 00
1086. Lumbar spine
7 50
1220. Head and face, partial examination for follow-up
1087. Pelvis
7 50
when area of injury has been demonstrated pre-
1088. Sacro-iliac joint and coccyx
7 50
viously
8 00
1089. Any two spinal regions
12 50
1221. Nasal bones
8 00
1089a. Any three spinal regions
17 50
1222. Nasal sinuses
11 00
1090. Sacro-iliac (special including lumbo-sacral facets)
A. & A.
1223. Mastoids
11 00
1100. Thoracic cage (not including spine) any one area
7 50
1224. Mandible - one side
8 00
22
23
Line
No.
Item
After-Care
Fee
KEY TO CODE LETTERS
1225. Cervical spine
11 00
X - General practice.
L - Gynecology (1) and/or obstetrics
1226. Dorsal spine
11 00
S - Practice limited to specialty.
(2).
1227. Lumbar spine
11 00
A - General surgery - major.
M ( 1) - Physical therapy.
1228. Pelvis
11 00
B — Orthopedic surgery.
M ( 2) - Tuberculosis and lung dis-
1229. Sacro-iliac joint and coccyx
11 00
C - Traumatic surgery - not inclusive
eases.
1230. Any two spinal regions
18 00
of major or open procedures
M ( 3) - Gastroenterology.
1231. Any three spinal regions
26 00
unless also qualified under A
1232. Sacro-iliac (including lumbo-sacral facets)
A. & A.
M ( 4) - Cardiology.
or B.
M ( 5) - Minor surgery.
1233. Thoracic cage (not including spine) any one area
11 00
D - Roentgenology (1) and/or radia-
M ( 6) - Anaesthesia.
1234. Lungs and heart (not including cardiac mensura-
tion (2).
M ( 7) - Plastic surgery.
tion)
11 00
E - Ophthalmology.
M ( 8) - Proctology.
1235. Cardiac mensuration (including fluoroscopy)
11 00
F - Laryngology (1), rhinology (2),
M ( 9) - Neuro surgery.
1236. Abdomen and gastrointestinal; flal plate for acute
otology (3).
M (10) - Public health and industrial
obstruction
11 00
G - Urology.
diseases.
1237. Oesophagus only (including fluoroscopy)
11 00
H - Dermatology (1) and/or syphilo-
M (11) - Metabolic diseases.
1238. Gastro-intestinal (oesophagus to cocum)
18 00
logy (2).
M (12) - Immunology and allergy.
1239. Gastro-intestinal (oesophagus to ampulla)
26 00
I - Neurology (1) and/or psychiatry
M (13) - Bronchoscopy.
1240. Colon by opaque enema
15 00
(2).
11 00
M (14) - Endocrinology.
1241. Gall bladder, simple
J - Internal medicine.
M (15) - Oral surgery.
1242. Gall bladder, Graham test, oral
15 00
K - Pathology (1), clinical pathology
1243. Intravenous or Stewart concentrate
26 00
M (16) - Vascular and veno-therapy.
(2), bacteriology (3), chemistry
1244. Genito-urinary - simple
11 00
OP - Osteopathic physician.
(4), serology (5), and/or hema-
1245. Genito-urinary — retrograde pylography (not in-
tology (6).
clusive of injection)
11 00
1246. Genito-urinary - pylography by excretion
18 00
1247. Teeth, complete dental study
8 00
1248. Foreign body, same as part involved
1249. Foreign body, search of respiratory or alimentary
canal
15 00
1250. Foreign body - eye, precise localization
18 00
1251. Bedside- - institutional - - add 15 per cent to normal
fee for part.
1252. Bedside - domicile
A. & A.
1253. Interpretation of films made elsewhere
A. & A.
1254. Radium therapy
A. & A.
1255. X-ray therapy
A. & A.
1256. When patients are treated by x-ray or
radium C-104 and C-4 must be filed.
(Lines 1257-1300 are blank.)
25
compensation medical bureau or laboratory under the Rules and Pro-
RULES AND REGULATIONS
cedure prescribed by the Industrial Commissioner as follows:
(a) The physician or medical bureau accused of misconduct shall be
Promulgated by the Industrial Commissioner covering Chapters
given twenty days notice of the charges in writing including a
bill of particulars setting forth the specific Section and Subdivision
258 and 930 of the Laws of 1935 amending the Workmen's
of the Law violated, and the time, date and place of the hearing.
Compensation Law
(b) Careful records and minutes shall be kept of the hearing.
"§ 10-a. Industrial Council
*
(c) These records, together with the report of the Board of the Medi-
"4. The Council shall (a) consider all matters submitted to it by the
cal Society or other Board, with its findings shall be submitted
Industrial Commissioner and advise him with respect thereto; (b) on its
to the Commissioner.
own initiative recommend to the Commissioner such changes of adminis-
Appeals filed by physicians and medical bureaus with the Industrial Coun-
tration as, after consideration, may be deemed important and necessary
cil shall be referred to the subcommittee designated by the Industrial
; (d) consider all matters connected with the practice of medi-
Council to ascertain the facts and report its findings to the Council for
cine submitted to it by the Commissioner or the Industrial Board; (e)
final action.
consider the qualifications for, or persons being considered for appoint-
(a) A physician or medical bureau may file an appeal with the Indus-
ment by the Commissioner to positions directly involving the practice of
trial Council from the decision of the Medical Society or other
medicine, and advise the Commissioner regarding the fitness of such per-
Board.
sons for appointment; (f) prescribe rules and regulations to govern the
procedure of investigations and hearings by Medical Societies or Boards
(b) A physician or medical bureau appealing and the Medical Society
of charges against authorized physicians and licensed compensation
or other Board whose decision was appealed from, shall be notified
medical bureaus as provided in Section 13-d of the Workmen's Compensa-
in writing indicating the time, date and place of hearing.
tion Law; (g) investigate on its own initiative charges made by a physi-
(c) The physician or medical bureau may be represented by counsel.
cian that he has been improperly refused authorization to do compensation
(d) Accurate stenographic or stenotype minutes of the hearing shall
work by a Medical Society or Board, or by the Commissioner and, if it
be kept for the file of the Commissioner and Industrial Council.
sustain the charges, recommend such authorization to the Commissioner;
(h) on its own initiative investigate and pass on charges of misconduct
3. When a physician, in association or in co-partnership with another
by either a physician or a compensation bureau authorized to treat injured
physician or physicians, or through another physician or physicians
workmen under this chapter; (i) review the determination of charges of
as employees or agents, maintains and operates one or more offices prin-
cipally for the treatment of injured claimants under the Workmen's
misconduct where the physician accused appeals from the decision of the
Medical Society or Board which took jurisdiction in the first instance.
Compensation Act, he shall apply for a compensation medical bureau
license.
In such cases the Council may reopen the matter and receive further evi-
dence. And the decision and recommendation of the Council shall be final,
4. All reports, except Form C-104 filed by attending physicians and specialists
binding and conclusive upon the Industrial Commissioner.
must be verified before a Notary Public or a Commissioner of Deeds, to
"5. The Council shall adopt Rules and Regulations to govern its own
insure their value as prima facie evidence in a compensation case.
proceedings. The Secretary shall keep a complete record of all its pro-
5. All specialists and consultants shall submit a report of their findings
ceedings which shall show the names of the members present at each
in triplicate, one copy to the Industrial Commissioner, one to the attend-
meeting and every matter submitted to the Council by the Commissioner
ing physician and one copy to the employer or insurance carrier. If a
and the action of the Council thereon. The record shall be filed in the
specialist acts as attending physician, he shall file a 48 hour and C-4
office of the Department. All records and other documents of the Depart-
reports with the employer or carrier and with the Industrial Commissioner.
ment shall be subject to inspection by the members of the Council."
Chapter 258, Laws of 1935.
6. All medical reports filed by attending physicians and specialists must
contain the authorization certificate number and code letters.
7. When it is necessary for the attending physician to engage the services
of a specialist, consultant or a surgeon, or to provide for physiotherapeutic
1. Medical Compensation Boards shall pass upon the applications of physi-
procedures, costing more than twenty-five dollars, or to provide for x-ray
cians within a reasonable time and notify the Industrial Commissioner
examinations or special diagnostic laboratory tests costing more than
of their action. If any such Board fails to recommend that a physician
ten dollars, he must secure authorization from the employer or insurance
be authorized to render medical care under Chapter 258 the physician
carrier or the Industrial Commissioner.
may appeal to the Industrial Council as provided in clause (G) of Sub-
E. G.-When the total fees for physiotherapeutic treatment approach
division 4 of Section 10-A of the Labor Law, and the Council thereafter
the sum of $25.00 the physician shall file an additional C-4 report and
will have sole jurisdiction.
request authorization as prescribed in Section 13-a-5.
2. Removal of physicians from panels and revocation of licenses of medical
This Rule also applies to hospitals, specialists, consultants and surgeons,
bureaus. Section 13-d.
who are actually engaged to perform such services.
The recommending Compensation Board or the Board of the County
If telephone request for such authorization is made, it should be con-
Medical Society in a County where any authorized physician has removed
firmed by letter. If such authorization is not forthcoming or is not
his office, shall investigate, hear and determine all charges of professional
denied within five working days, or if such denial is not justified
or other misconduct by any authorized physician or by any licensed
medically or otherwise, the special services required for the patient's
welfare should be proceeded with on the ground that authorization has
[24]
been unreasonably withheld.
27
26
18. No license is required for an employer to operate a first aid station
Such authorization is not required in an emergency under the provisions
of Section 13-A-5.
for emergency treatment, but no subsequent treatments are to be rendered
by any one, other than a qualified physician on the Minimum Fee Schedule
8. The authority of an employer for the services of a specialist in excess
basis.
of a $25.00 fee, applies only to the necessity for such services, but the
19. No advertising matter of any nature on compensation work, by or on
choice of such specialist is entirely within the jurisdiction of the injured
behalf of authorized physicians, medical bureaus or laboratories shall be
worker.
permitted.
9. When it is in the interest of the injured employee, and where an x-ray
20. No insurance company or self-insurer may reduce the size of NOTICE
is required and it is impossible to secure the services of a qualified
TO EMPLOYEES (FORM C-105) which is to be posted in all places
x-ray specialist, the Board of the local County Medical Society may
of employment covered by the Act, unless such permission is granted on
designate a specially qualified individual to take x-ray pictures under
application to the Industrial Commissioner.
the supervision of the attending physician. The attending physician,
however, shall render a bill for such service to the employer. This in
21. A physician who testifies at hearings or examines claimants or partici-
no way, however, deprives the employer or insurance carrier from having
pates in examinations for evidential material for compensation case
other x-ray pictures taken if they so desire.
hearing purposes only, may accept fees for such services from claimants,
10. A physician authorized to treat workmen's compensation cases, when
employers or carriers.
requested to supersede another physician, must, before beginning treat-
22. Hospitals shall render bills for board and room accommodations, medical
ment of such patient, make reasonable effort to communicate with the
and surgical supplies and nursing facilities.
attending physician to ascertain the patient's condition. The superseding
Hospitals may render bills for x-ray, physiotherapeutic, anaesthesia and
physician must also advise the attending physician of the name of the
pathologic services when rendered by or under the supervision of salaried
person who has requested him to assume care of the case and state the
physicians on the staff.
reason therefor. If the second physician cannot contact the attending
The names and qualifications of all physicians and persons rendering
physician, and the claimant's condition requires immediate treatment,
services for which charges are made by hospitals must be included in all
the said physician should advise the doctor previously in attendance
bills and all medical and x-ray reports shall be promptly filed with the
within 48 hours that he now has the patient in his care. The preceding
employer or its insurance carrier and the Department of Labor.
physician shall supply the succeeding physician with a complete history
of the case and all pertinent medical data.
11. In the event of a serious accident requiring immediate emergency medical
Rules Governing Recommending of Authorized Physicians
aid, an ambulance or any physician may be called to give first aid
by Insurance Carriers and Employers and the Procedure
treatment.
to be Followed by Medical Inspectors and Consultants
12. A registered physiotherapist may treat workmen's compensation cases at
his own office or bureau when the case is referred to him by an authorized
23. The supplying of names of authorized physicians by insurance carriers
physician. The authorized physician should, however, give written
to their policyholders is in contravention to Section 13, as amended by
directions to the physiotherapist as to the kind of treatment to be
Chapter 258 of the Laws of 1935. Such policyholders and all employers
rendered and the number of treatments to be given. These directions
may secure a list of all authorized physicians in the vicinity of their
must be given in writing by the physician and shall constitute a part
places of business by applying to the Industrial Commissioner of the
of the record of the case.
Department of Labor.
13. Bills for x-rays and consultations shall be submitted for payment
24. Any physician who acts in the capacity of medical inspector for an
directly to the employer or carrier by the specialist rendering the service.
insurance carrier or employer in the case of an injured employee under
These services must be authorized in writing by the physician in
the care of another physician shall not participate in the treatment of
attendance.
said injured employee except in the operation of a rehabilitation clinic or
14. Physicians treating claimants in hospitals may secure the signature of
bureau under Section 13-j of the Law. Nothing herein contained affects
claimant for authorization to obtain copies of any necessary hospital
the right of transfer as provided in Section 13-a (3).
records.
25. When a medical examination is had under Section 13-a (4) it shall
15. The physician in attendance in public hospitals must be the judge as to
be by a qualified physician at a place reasonably convenient to the
when the "emergency status" of the case has terminated. In case of a
claimant and in the presence of the claimant's physician, if in the latter's
dispute the matter shall be referred to the Compensation Board of the
opinion his presence is necessary. A duplicate copy of all notices of
Medical Society of the County in which the hospital is located, for
requests for examinations must be sent to the attending physician.
immediate decision.
26. No physician designated by an insurance carrier or an employer as a
16. Medical inspectors of insurance companies shall be admitted to hospitals
consultant in the case of an injured employee, shall subsequently par-
or other institutions where injured employees are confined, upon proper
ticipate in the medical or surgical care of said injured employee, except
identification, for the purpose of complying with Section 13-j.
with the written consent of the injured employee and his attending
physician. Nothing herein contained affects the right of transfer as
17. Hospitals and dispensaries shall not operate a medical bureau or clinic
provided in Section 13-a (3).
for the purpose of rendering medical care and treatment to compensation
cases. Hospitals and dispensaries shall not render medical care and
treatment to ambulatory compensation cases except for the emergency
treatment.
28
Rules Governing the Licensing of and Operation of
Compensation Medical Bureaus
27. The character and frequency of accidents, the number of employees in
a given plant and the availability of qualified medical care in the imme-
diate vicinity of the place of employment should be considered in relation
to the authorization of an employer's compensation medical bureau.
28. The bureau should be located in the industrial plant or in the immediate
vicinity.
29. The question of the necessity of the presence of a physician during work-
ing hours, or the availability of a physician at stated hours should be
determined by an inspection of the plant to ascertain the nature of the
hazards and the frequency of accidents.
30. The bureau shall be well housed with sufficient space, light and air and
shall conform to reasonable sanitary requirements. Proper facilities in
the form of personnel for assistance in emergencies, instruments, steril-
izers, dressings, drugs, shall be available at all times and in amounts
proportionate to the size of the plant and the number of employees. Such
facilities shall be adequate for more than mere emergency care and for
the more severe type of industrial injury.
31. A bureau license may be given for a stated project which, because of the
hazards of the project and the frequency of accidents, requires continued
medical care and such license shall be for the life of the given project
only. In such cases all employees of all subcontractors shall be covered
by the license.
32. No license shall be issued to an employer to cover any but his own
employees except as indicated in Rule No. 31.
33. First aid stations-No license is required to operate a first aid station
by an employer of labor. Such first aid or emergency station should be
properly equipped for first aid in accordance with the type of hazard
encountered at the particular place of employment.
34. Form C-105, a notice of the rights of an injured employee and the
responsibilities of the employer, shall be posted in each compensation
medical bureau and first aid station.
35. All compensation medical bureaus when operated by summer camps
and other institutions, wherein such camps and institutions are operating
for profit, shall be charged a license fee of $25.00 per annum for the
operation of such medical bureaus which are in operation for six months
of the year or less.
FRIEDA S. MILLER,
Industrial Commissioner
March 1, 1939
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"ocrText": "Minimum Medical Fee Schedule\nfor\nMedical Treatment and\nCare of Injured Employees\nEstablished by the Industrial Commis-\nsioner of the State of New York in\naccordance with Chapters 258 and 930\nof the Laws of 1935 amending the\nWorkmen's Compensation Law.\nThis Schedule applies to the\nentire State of New York\nPrice 10 Cents\n1\nNEW YORK STATE\nDEPARTMENT OF LABOR\nFRIEDA S. MILLER, Industrial Commissioner\nMICHAEL J. MURPHY, Deputy Commissioner\nGODFREY P. SCHMIDT, Deputy Commissioner\nROSE SCHNEIDERMAN, Secretary\nDIVISION OF WORKMEN'S COMPENSATION\nRalph R. Boyer, Director\nMedical Registration Unit\nHugh J. Murphy, Registrar\nINDUSTRIAL COUNCIL\nEmployee Representatives\nJohn Halkett, Brooklyn\nThomas J. Curtis, New York City\nEdward W. Edwards, Elmhurst, L. I.\nJames V. Barry, Woodside, L. I.\nAnna M. Wolff, New York City\nEmployer Representatives\nMaxwell S. Wheeler, Buffalo\nMark A. Daly, Buffalo\nCharles M. Winchester, Albany\nMax Meyer, New York City\nSylvan Stix, New York City\nPhysicians\nW. D. Johnson, M.D., Batavia\nE. C. Podvin, M.D., New York City\nHorace E. Ayers, M.D., New York City\nAlbert W. Bailey, D.O., Schenectady\nHenry Joachim, M.D., Brooklyn\n4-10-40-20,000 (6-7718)\nNOTICE\n\"§ 13. Treatment and care of injured employees. (a) The employer shall\npromptly provide for an injured employee such medical, surgical or other\nattendance or treatment, nurse and hospital service, medicine, crutches and\napparatus for such period as the nature of the injury or the process of\nrecovery may require. The employer shall be liable for the payment of the\nexpenses of medical, surgical or other attendance or treatment, nurse and\nhospital service, medicine, crutches, and apparatus necessitated by the injury\nof an employee, for such period as the nature of the injury or the process of\nrecovery may require. All fees and other charges for such treatment and\nservices shall be limited to such charges as prevail in the same community for\nsimilar treatment of injured persons of a like standard of living.\n\"The Commissioner shall prepare and establish a schedule for the State, or\nschedules limited to defined localities, of minimum charges and fees for such\nmedical treatment and care, to be determined in accordance with and to be\nsubject to change pursuant to rules promulgated by the Commissioner. Before\npreparing such schedule for the State or schedules for limited localities the\nCommissioner shall request the president of the Medical Society of the State\nof New York to submit to him a report on the amount of remuneration deemed\nby such society to be fair and adequate for the types of medical care to be\nrendered under this Chapter, but consideration shall be given to the view of\nother interested parties. The amounts payable by the employer for such\ntreatment and services shall in no case be less than the fees and charges\nestablished by such schedule. Nothing in this schedule, however, shall prevent\nvoluntary payment of amounts higher than the fees and charges fixed therein,\nbut no physician rendering medical treatment or care may receive payment\nin any higher amount unless such increased amount has been authorized by\nthe employer, or by decision as provided in Section 13-g herein.\" Chapter\n258, Laws of 1935.\n\"Nothing in this section shall be construed as preventing the employment of\na duly authorized physician on a salary basis by an authorized compensation\nmedical bureau or laboratory.\" Chapter 930, Laws of 1935.\nFollowing several hearings and conferences upon the subject, and upon the\nrecommendation of the Industrial Council, the following is hereby established\nunder the above provisions as the Minimum Fee Schedule for Medical Treat-\nment and Care of Injured Employees, to apply to the entire State of New\nYork, effective immediately.\nFRIEDA S. MILLER,\nIndustrial Commissioner.\nNew York State\nDepartment of Labor,\nMay 15, 1938.\n[3]\nMINIMUM MEDICAL FEE SCHEDULE\n1. Section 13 (a) (Workmen's Compensation Law) requires that the employer\nshall provide medical care for injured employees and that the Commis-\nsioner shall establish and promulgate \"a schedule for the State, or sched-\nules limited to defined localities, of minimum charges and fees for such\nmedical treatment and care\"-etc. And further, \"All fees and other\ncharges for such treatment and services shall be limited to such charges\nas prevail in the same community for similar treatment of injured persons\nof like standard of living.\"\n2. This schedule to apply to the entire State of New York, effective immedi-\nately.\n3. MINIMUM FEES. Section 13-d 2 (d), requires that the Commissioner\nshall remove from the list of physicians authorized to render medical care\nany one who \"has rendered medical service under this Chapter for a fee\nless than fixed by the Commissioner as the minimum rate in his locality.\"\nSection 13 (a) says, \"The amounts payable by the employer for such treat-\nment and services shall in no case be less than the fees and charges estab-\nlished by such schedule.\"\n4. Nothing in this schedule shall prevent voluntary payment of amounts\nhigher than the fees and charges fixed therein, but no physician rendering\nmedical treatment or care may receive payment in any higher amount\nunless such increased amount has been authorized by the employer or by\ndecision as provided in Section 13-g herein.\n5. Section 13-b 1 (g). Authorization of physician by Commissioner. \"No\nperson shall render medical care under this Chapter without such author-\nization of the Commissioner\"\netc.\nEXCEPTIONS:\nA. Any licensed physician may render emergency care.\nB. Any member of a constituted hospital staff may render care while\nthe patient remains within the institution.\nC. Technical assistants when under active personal direction of an\nauthorized physician.\nD. Registered physiotherapists under written specific direction of\nauthorized physician.\n6. NO CLAIM for medical or surgical treatment is valid or enforceable\nunless\nWITHIN 48 HOURS, (*) following first treatment, a preliminary report\n(C-104) is filed; and\nWITHIN 15 DAYS, (*) thereafter, a complete report (C-4) is filed.\nAddendum A.\nPROGRESS REPORTS\nIf the attending physician is requested in writing by the employer,\ncarrier, Industrial Board or Industrial Commissioner, he shall file a\nprogress report on a form to be provided, every three weeks (or at less\nfrequent intervals if SO requested).\nEXCEPTIONS:\nIf patient is discharged from treatment within 48 hours after first\ntreatment, only a notarized C-4 report shall be filed marked \"FINAL.\"\n* Make triplicate record. Send one to your district office of the State Depart-\nment of Labor (see back of blanks). Send one to carrier, if known, or employer.\nKeep one for your record.\n[5]\n7\n6\n7. EMERGENCY. Claim may need to be sustained by record of details that\n15. PRORATION OF SCHEDULED UNIT FEE. When the schedule specifies\nestablish fact of emergency.\na unit fee for a definite treatment and period of after care, and the patient\nis transferred from one to another physician, the employer (or carrier) is\n8. PAYMENT OF MEDICAL FEES. Section 13-f. No physician shall\nresponsible for the amount stated in the schedule. If the concerned physi-\ncollect or receive a fee from the injured claimant. A hospital shall not\ncians agree upon amount of proration they shall render separate bills\nbe entitled to remuneration paid to a physician on its staff.\naccordingly; in the event of no agreement or disagreement, the matter\nSection 13-f (1). \"Fees for medical services shall be payable only to a\nshall be settled by the Board of the local County Medical Society, or by\nphysician or other lawfully qualified person permitted by Section 13-b of\nan arbitration committee appointed by it-without cost to the contestants.\nthis Chapter, or to the agent or to the executor or administrator of the\n16. Presence of physician during examination by employer's (or carrier's)\nestate of such physician.\"\nphysician, routine fee.\nWRITTEN NOTICE OF CONTEST by the employer (or carrier) shall be\nfiled of the amount of the bill for medical care or hospital service within\n17. Investigation and observation (without examination) by medical inspector\n30 days after receipt of bill, or the right to an impartial examination of\nacting for employer (or carrier) ; if presence of injured employee's physi-\nthe fairness of the amount claimed \"shall be deemed to be waived and the\ncian is required by carrier or employer the fee to the employee's physician\namount claimed by such physician or hospital shall be deemed to be the\nshall be $4.00.\nfair value of the services rendered by him or it.\"\n18. Physician of \"especially qualified\" enrollment, who makes written opinion\nor testimony, fee fixed by Commissioner, Section 13 (d).\n9. DISAGREEMENT \"as to value of medical aid rendered under this Chapter\nshall be decided by an arbitration committee.\" Section 13-g (2).\n19. PENALTY FEES. \"When transfer of patient by employer (or carrier)\nhas not been authorized under this Section,\" Section 13-a (3) (2) : Same\n9A. NO INSURANCE CASES. Sec. 13-g of Chapter 258 of the Laws of 1935\nas total paid to other physicians or as determined by arbitration committee.\nhas been amended effective July 1, 1940 as follows:\n20. Owners of plants requiring high frequency treatments may apply to the\n(4) In claims where the employer has failed to secure compensation to\nIndustrial Commissioner for modification of the established fees in the\nhis employees as required by section fifty of this chapter, the board may\nmedical fee schedule. The Commissioner will cause an investigation to be\nmake an award for the value of medical services or treatment rendered\nmade in each instance and act upon the record when established. This\nto such employees, in accordance with the schedule of fees and charges\nprivilege will be granted only on the assurance that it will not interfere\nprepared and established under the provisions of section thirteen-a of\nwith the employee's right of free choice of physician.\nthis chapter. Such award shall be made to the physician or hospital\nentitled thereto. A default in the payment of such award may be\n21. In order to facilitate the prompt payment of medical bills, a discount of\nenforced in the manner provided for the enforcement of compensation\n5 per cent will be allowed on all medical bills in amounts of $15.00 or\nawards as set forth in section twenty-six of this chapter.\nover, if paid within 30 days, except on controverted cases when the 30-day\nlimit shall run from the date that a decision is rendered finding the\nIn all cases coming under this subdivision the payment of the claim of\nclaim compensible.\nthe physician or hospital for medical or surgical services or treatment\nshall be subordinate to that of the claimant or his beneficiaries.\n10. \"A. AND A.\" means Authorization and Arrangement established by agree-\nGENERAL MEDICO SURGICAL SERVICE\nment between the physician and the carrier or employer. This designation\nhas been applied where the extreme range of variation and complexity\nLine\nin the individual problem renders a fixed minimum standard impractical.\nNo.\nItem\nAfter-Care\nFee\n49. First visit, home call, including reports\n$4 00\n11. CONCURRENT FEES for two or more physicians for an identical period\n50. First office visit, including reports\n3 00\nof care and treatment will not be allowed except when warranted by com-\n51. Office call\n2 00\nplication or noted need for assistance. When all the required care and\n52. Home call - day\n3 00\ntreatment reasonably falls within the range of qualifications of one physi-\n53. Home call - night (if call received by doctor\ncian no other shall claim a fee; only one physician shall be in charge of a\nbetween 12 M to 7 A.M.)\n5 00\ncase. Fees for assistants and consultants must be justified.\n54. Hospital call\n2 00\n12. MULTIPLE INJURIES treated by one doctor requiring extensive surgical\n55. Consultation with specialist, same fee as regular\nvisit.\ndressings or care are to be charged for the greatest plus one-half of the\n56. Salvarsan, plus cost of drug\n5 00\nlesser fees but limited to two times the greatest fee. Superficial injuries\n57. Tetanus Antitoxin, add cost of drug to routine fee.\nnot requiring extensive attention are not to carry cumulative charges.\n58. Assistant to surgeon\n15 00\nThis Rule does not apply to multiple x-ray and pathological examinations.\n(In hospital with interne staff no charge to\nbe made for service of interne or assistant.)\n13. EXTENSIVE AND UNUSUAL DRESSINGS. When a patient requires\nunusual, extensive and extraordinary dressings, the cost of material\n59. Strapping of joints.\n64. Strapping of shoulder, routine service 1ee plus\n1 00\n(enumerated and noted in bill) may be added to schedule of fee for service.\n65. Strapping of hip, routine service fee plus\n1 00\n14. UNIT FEES. When the schedule specifies a fee for a service and a period\n66. Strapping of sacro-lumbar spine, routine service fee\nplus\n1 00\nof after care, and for any reason there is a transfer of the care and treat-\n67. Strapping of thorax. routine service fee plus\n1 00\nment to a second or other physician, the stated amount in the schedule\nshall cover the combined fee of all.\n(For fracture of ribs, see Line 164)\n8\n9\nLine\nLine\nNo.\nItem\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\nX-RAY DEMONSTRATION OF INJURED PARTS\n130. Gas each additional one-half hour\n5 00\n131. Ether up to one-half hour\n5 00\n80. Lines Nos. 83 to 102 inclusive represent\n132. Ether each additional one-half hour\n5 00\nscope and fees for physicians with the\n133. Chloroform up to one-half hour\n5 00\n\" X qualification.\n134. Chloroform each additional one-half hour\n5 00\n81. Such x-ray demonstration of injured parts\n135. Spinal for first hour\n15 00\nis limited to those patients who are under\n136. Spinal over one hour\n20 00\nhis general medical care.\n137. Rectal, when performed by other than operator\n15 00\n83. Fees are for regional examination, size\n138. Rectal over one hour\n20 00\nand number of films not relevant.\n139. Intravenous anaesthetic to one-half hour\n10 00\n84. Teeth, complete dental study\n5 00\n140. Intravenous anaesthetic to one hour\n15 00\n85. Single finger\n2 50\n141. Intravenous anaesthetic over one hour\n20 00\n86. Single toe\n2 50\n142. Local anaesthesia by operator is part of\n87. Hand (including fingers)\n4 00\noperating fee, as scheduled.\n88. Wrist (including carpus and lower 1/3 forearm)\n4 00\n89. Forearm mid one-third\n4 00\nFRACTURES\n90. Elbow (including upper one-third of forearm and\n4 00\n150. Compound fractures - increase fee 50%.\nsupracondyles)\n151. Skull operative, not within dura\n3 wks.\n100 00\n91. Humerus mid one-third\n4 00\n152. Skull involving work within dura\n3 wks.\n150 00\n92. Foot (including toes)\n4 00\n93. Ankle (including lower three inches of leg)\n4 00\n153. Skull non-operative, on a per visit basis.\n94. Leg mid one-third\n154. Maxilla, closed\n3 wks.\n35 00\n4 00\n155. Mandible (uncomplicated) unilateral\n3 wks.\n50 00\n95. Knee (including four inches above and below joint)\n4 00\n96. Femur mid one-third\n4 00\n156. Mandible (uncomplicated) bilateral\n3 wks.\n100 00\n157. Malar\n3 wks.\n35 00\n97. Femur upper one-third\n4 00\n98. Shoulder joint\n5 00\n158. Nose\n3 wks.\n25 00\n99. Clavicle\n5 00\n159. Nasal septum\nA. & A.\n160. Trephine\n3 wks.\n100 00\n100. Scapula\n5 00\n101. Hip joint\n7 50\n161. Clavicle, closed\n3 wks.\n40 00\n102. Nasal bones\n162. Clavicle, open\nA. & A.\n5 00\n163. Scapula\n3 wks.\n40 00\n164. Ribs, strapping of\n5 00\n165. Vertebrae, contiguous, bodies or laminae, closed\n2 mos.\n100 00\n103. Physical therapy, inclusive of any and all modalities.\n2 00\n166. Vertebral processes, non-operative\n10 00\n104. Electrocardiogram\n10 00\n167. Vertebrae, open\nA. & A.\n105. Allergy test\nA.&A.\n168. Humerus, closed\n2 mos.\n100 00\n106. Immunology\nA.&A.\n169. Humerus, open\n2 mos.\n150 00\n107. Spinal puncture\n10 00\n170. Radius or ulna, closed\n2 mos.\n50 00\n108. Spinal puncture with manometric determination\n15 00\n171. Radius or ulna, open\n2 mos.\n75 00\n109. Blood transfusion, direct\n50 00\n172. Radius and ulna, closed - shaft\n2 mos.\n100 00\n110. Blood transfusion, indirect (citrate)\n25 00\n173. Radius and ulna, open - shaft\n2 mos.\n150 00\n111. Fee for donor, Regular Blood Donors'\n174. Colles fracture, closed\n2 mos.\n65 00\nAssociation fee.\n175. Colles fracture, open\n2 mos.\n110 00\n112. Gastric lavage (poison, etc.)\n10 00\n176. Elbow (including humerus, radius and ulna), closed.\n2 mos.\n75 00\n113. Burns, according to area involved and per visit\nA. & A.\n177. Elbow (including humerus, radius and ulna), open\n2 mos.\n110 00\n114. Skin patch test\nA. & A.\n178. Carpal bones, closed\n2 mos.\n50 00\n115. Abdominal paracentesis\n10 00\n179. Carpal bones, open\n2 mos.\n100 00\n116. Uterine Curettage, 3 weeks after care\n50 00\n180. Metacarpals (one or more), closed\n3 wks.\n30 00\n117. Injection, veno surgery\n5 00\n181. Metacarpals (one or more), open\n2 mos.\n75 00\n182. Finger - one\n3 wks.\n20 00\nANAESTHESIA\n183. Fingers, multiple on one hand\n3 wks.\n35 00\n125. When given by other than operating sur-\n184. Femur, closed\n2 mos.\n150 00\ngeon. Period of time to be measured\n185. Femur, open\n2 mos.\n175 00\nfrom beginning of induction of anaes-\n186. Patella, closed\n3 wks.\n50 00\nthesia to recorded end of operation.\n187. Patella, open\n6 wks.\n100 00\n126. Anaesthesia, given by a medical anaesthetist speci-\n188. Tibia, closed\n2 mos.\n75 00\nfically called, an additional fee of\n5 00\n189. Tibia, open\n2 mos.\n110 00\n127. Gas, first one-fourth hour\n5 00\n190. Fibula, closed\n2 mos.\n50 00\n128. Gas up to one-half hour\n10 00\n191. Fibula, open\n2 mos.\n75 00\n129. Gas up to one hour\n15 00\n192. Tibia and fibula, closed\n2 mos.\n100 00\n10\n11\nLine\nLine\nNo.\nItem\nNo.\nItem\nAfter-Care\nFee\nAfter-Care\nFee\n193. Tibia and fibula, open\n2 mos.\n150 00\nAMPUTATIONS\n194. Potts fracture, closed\n2 mos.\n75 00\n275. Arm, disarticulation, uncomplicated\n6 wks.\n150\n00\n195. Potts fracture, open\n2 mos.\n110 00\n276. Arm, thru head or neck\n6 wks.\n100\n00\n196. Metatarsal bones, closed\n3 wks.\n30 00\n277. Arm, below neck\n6 wks.\n75 00\n197. Metatarsal bones, open\n2 mos.\n75 00\n278. Forearm\n6 wks.\n75 00\n198. Toes - single toe - first toe\n3 wks.\n20 00\n279. Hand at wrist\n6 wks.\n75 00\n199. Toes — single toe - other than first\n3 wks.\n15 00\n280. Carpus\n6 wks.\n60 00\n200. Toes - multiple on same foot\n3 wks.\n25 00\n281. Metacarpus\n6 wks.\n50 00\n201. Sacrum, closed\n3 wks.\n50 00\n282. Phalanx\n6 wks.\n30 00\n202. Pelvis, one bone\n3 wks.\n50 00\n283. Thigh, disarticulation\n6 wks.\n150 00\n203. Pelvis, multiple\n3 wks.\n75 00\n284. Leg at knee\n6 wks.\n100 00\n204. Pelvis, open\nA. & A.\n285. Patella, excision\n6 wks.\n75 00\n205. OsCalcis, closed\n2 mos.\n50 00\n286. Femur, head and neck\n6 wks.\n150 00\n206. OsCalcis, open\n2 mos.\n100 00\n287. Femur\n6 wks.\n100 00\n207. Astragalus, closed\n2 mos.\n40 00\n288. Knee\n6 wks.\n100 00\n208. Astragalus, open\n2 mos.\n80 00\n289. Tibia or fibula\n6 wks.\n100 00\n209. Tarsal bones, others, closed\n2 mos.\n30 00\n290. Foot at ankle joint\n6 wks.\n75 CO\n210. Tarsal bones, others, open\n2 mos.\n60 00\n291. Foot thru metatarsus\n6 wks.\n75 00\n211. Multiple fractures, not in same hand or\n292. OsCalcis (Syme's amp.)\n6 wks.\n100 00\nfoot: Add to the greater fee a sum equal\n293. Phalanx (toe)\n6 wks.\n30 00\nto 50 per cent of each lesser, not exceed-\n294. Astragalectomy\n2 mos.\n100 00\ning two times the greater.\n295. Laminectomy or other osteoplastic\n2 mos.\n200 00\n12.\nMultiple injuries treated by one doctor, requiring extensive\n296. Coccyx, removal\n3 wks.\n50 00\nsurgical dressings or care, are to be charged for the\n297. Spinal fusion, involving bone inlay\n2 mos.\n200 00\ngreatest plus one-half of the lesser fees but limited to\n298. Removal of semi-lunar cartilage\n2 mos.\n100 00\ntwo times the greatest fee. Superficial injuries not\n299. Rib excision or resection\n3 wks.\n50 CO\nrequiring extensive attention are not to carry cumulative\ncharges. This Rule does not apply to multiple x-ray\n300. Arthrodesis hip\n2 mos.\n150 00\nor pathological examinations.\n301. Arthrodesis wrist\n2 mos.\n100 00\n15.\nProration of scheduled unit fee: When the schedule\n302. Arthrodesis knee\n2 mos.\n100 00\nspecifies a unit fee for a definite treatment and period\nof after-care, and the patient is transferred from one to\n303. Arthrodesis shoulder\n2 mos.\n100 00\nanother physician, the employer (or carrier) is respon-\n304. Bone graft for non-union of femur including post-\nsible for the amount stated in the schedule. If the con-\noperative therapy\n4 mos.\n200 00\ncerned physicians agree upon amount of proration they\nshall render separate bills accordingly; in the event of\n305 Bone graft for non-union of tibia, including post-\nno agreement or disagreement, the matter shall be settled\noperative therapy\n4 mos.\n175 00\nby the Board of the local County Medical Society of the\n306. Bone graft humerus, including post-operative\nfirst attending physician, or by an arbitration com-\nmittee appointed by without cost to the contestants.\ntherapy\n4 mos.\n175 00\n22.\nIf in the course of treatment consultation is necessary,\n307. Bone graft - forearm, including post-operative\nauthorization in accordance with Section 13-A-5 should\ntherapy\n4 mos.\n175 00\nbe obtained except in emergency.\nSURGICAL PROCEDURES\nDISLOCATIONS\nINCISION\n250. Tempero-mandibular\n10 00\n251. Spine, open\n6 mos.\n150 00\n325. Incision for superficial abscess as furuncle or boil\n3 00\n252. Spine, closed\n2 mos.\n100 00\n326. Incision for abscess, carbuncle with multiple pockets.\n5 00\n327. Incision of deep abscess or infection\n25 00\n253. Shoulder\n3 wks.\n40 00\n254. Shoulder, recurrent — operation\nA. & A.\n328. Paronychia\n5 00\n3 wks.\n35 00\n329. Laparotomy, exploratory only\n3 wks.\n100 00\n255. Elbow, closed\n256. Elbow, open\n3 wks.\n75 00\n330. Operation on viscera\nA. & A.\n331. Simple bowel resection\n3\n257. Finger, reduction and splint\n5 00\nwks.\n150 00\n258. Finger, open\n3 wks.\n40 00\n332. Encephalogram\nA. & A.\n259. Hip\n3 wks.\n75:00\n333. Osteomyelitis\nA. & A.\n260. Knee\n3 wks.\n60 00\nEXCISION\n261. Ankle\n3 wks.\n40 00\n262. Astragalus, closed\n3 wks.\n50 00\n350. Removal of nail, finger or toe, including local\n263. Astragalus, open\n2 mos.\n100 00\nanaesthetic\n5 00\n264. OsCalcis, closed\n3 wks.\n50 00\n351. Excision of sub-deltoid bursa\n3 wks.\n50 00\n265. OsCalcis, open\n2 mos.\n100 00\n352. Excision of pre-patellar bursa\n3 wks.\n35 00\n266. Toe, reduction and splint\n5 00\n353. Pilonidal cyst\nA. & A.\n267. Wrist closed\n3 wks.\n35 00\n354. Ganglion by excision\n3 wks.\n35 00\n13\n12\nLine\nLine\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\nNo.\nItem\nREPAIR\n\" SB \" QUALIFICATION\n365. Tendon, one primary\n35 00\n425. Orthopedist, complete office examination or con-\n3 wks.\n10 00\nsultation\n366. Tendon, each additional\n$10 00, maximum 100 00\n426. Orthopedist, check-up\" examination of referred\n367. Tendon, secondary\nA. & A.\n5 00\n370. Nerve suturing, primary, single\n3 wks.\n35 00\npatient\n427. Orthopedist, subsequent examination or care not\n371. Nerve suturing, each additional\n$10 00, maximum\n100 00\nincluded in scheduled \" after care\"\n3 00\n372. Nerve suturing, secondary\nA. & A.\n375. Hernia, single (including assistant's fee)\n8 wks.\n75 00\n376. Hernia, double (including assistant's fee)\n8 wks. 100 00\n\" SA \" QUALIFICATION\n377. Hernia, recurrent\nA. & A.\nA. & A.\n430. Surgeon, complete office examination or consulta-\n378. Hernia by injection\n10 00\ntion\n379. Hernia, diaphragmatic\nA. & A.\n431. Surgeon, \"check-up\" examination of referred\n380. Hernia, post-surgical (including assistant's fee)\n8 wks.\n100 00\n5 00\n381. Hernia, ventral (including assistant's fee)\n8 wks. 100 00\n432. Surgeon, patient subsequent examination or care not in-\n382. Hernia, strangulated.\nA. & A.\n2 00\ncluded in scheduled after care\n385. Suture of soft tissue wound, such as -\n386. Skin: Routine fee plus $1.00 for each suture\nmaximum\n10 00\n387. Fascia: Routine fee plus $1.00 for each suture\nmaximum\n10 00\n\" SC \" QUALIFICATION\n388. Muscle: Routine fee plus $1.00 for each suture\nmaximum\n10 00\n438. Surgeon, first care, if not otherwise scheduled\n3 00\n390. Superficial lacerations: Office Visit.\n439. Surgeon, subsequent office visits or hospital visit\n2 00\n440. Surgeon, patient's home or place of employment.\n3 00\nFOREIGN BODIES\nDay\n441. Surgeon, patient's home or place of employment.\n392. Foreign body extraction, intracutaneous;\nNight, 12 Midnight to 7 A. M\n5 00\noffice fees.\n393. Foreign body extraction, subcutaneous, without\nanaesthetic\n5 00\nEAR, NOSE AND THROAT\n394. Foreign body extraction, subcutaneous, with\n\" SF QUALIFICATION\nanaesthetic\n10 00\n395. Foreign body extraction, deep\n3 wks.\n25 00\n450. Nose, complete office examination or consulta-\n10 00\n396. Note: Above extractions do not include\ntion and report\nremoval of foreign body from eye or orbit.\n451. Nose, subsequent office examination or consulta-\n5 00\ntion\n452. Nose, extensive study, various charges according\nA. & A.\nCONSULTATIONS AND CONSULTANT CARE\nto special tests\n3 wks.\n25 00\n453. Nasal bones, fracture\n\" SG \" QUALIFICATION\n454. Submucuous resection of nasal septum\n2 wks.\n75 00\n455. Otoscopic examination, including functional test of\n10 00\n400. Urologist office consultation fee, complete, but not\ncochlea\ninclusive of cystoscopy or x-ray demonstration\n15 00\n456. Ear examination, including functional tests of\nA. & A.\n401. Urologist, subsequent office or hospital visits, ex-\ncochlea and labyrinth\nclusive of \" after care as specified\n3 00\n457. Direct laryngoscopy; instrumentation with laryn-\ngoscope (inclusive of removal of foreign body or\n25 00\nbiopsy)\n\" SI \" QUALIFICATION\n458. Direct laryngoscopy, removal of growth\n1 wk.\n50 00\n1 wk.\n50 00\n410. Neurologist or psychiatrist, complete office exami-\n459. Bronchoscopy\n460. Bronchoscopy, with removal of biopsy\n50 00\nnation or consultation\n20 00\n461. Bronchoscopy, with foreign body extraction\n75 00\n411. Neurologist or psychiatrist, for subsequent office\n50 00\ndiagnostic consultation\n5 00\n462. Oesophagoscopy\n50 00\n412. Neurologist or psychiatrist, for other subsequent\n463. Oesophagoscopy, with removal of biopsy\n3 00\n464. Oesophagoscopy, with foreign body extraction\n75 00\noffice visits\n1 wk.\n40 00\n465. Tonsillectomy\n3 days\n75 00\n466. Tracheotomy\n3 wks.\n100 00\n\" SJ \" QUALIFICATION\n467. Mastoid - simple*\n468. Mastoid - radical*\n3 wks.\n150 00\n420. Internist, complete office examination or consulta-\ntation\n10 00\n* RADICAL MASTOID - fee allowed only when mastoid and middle ear cavities are made\n421. Internist, subsequent office visits\n3 00\none bony wall removed.\n14\n15\nLine\nLine\nNo.\nItem\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\n469. Mastoid - bilateral\n3 wks.\n225 00\n602. Fixation of kidney\nA. & A.\n471. Antrotomy puncture with irrigation\n10 00\n603. Kidney calculi-removal\n3 wks.\n150 00\n472. Antrotomy - window\n3 wks.\n50 00\n604. Nephrotomy\n3 wks.\n100 00\n473. Antrotomy - radical\nA. & A.\n605. Cystotomy\n3 wks.\n75 00\n474. Antrotomy - subsequent irrigations\n5 00\n606. Cystoscopy without X-ray\n25 00\n475. Epistaxis, arrest of bleeding, office visit.\n607. Cystoscopy including catherization ureters\n35 00\n476. Epistaxis, with electrocoagulation or electro-\n608. External Urethrotomy\nA. & A.\ncauterization\n10 00\n609. Hydrocele - radical\n3 wks.\n50 00\n477. Epistaxis, without electrocoagulation, office visit.\n610. Hydrocele- - tapping\n10 00\n478. Myringotomy, in office (puncture)\n5.00\n611. Orchidectomy\n3 wks.\n60 00\n479. Nyringotomy, at hospital or home or other place\n10 00\n612. Epididymectomy\n3 wks.\n75 00\n480. Subsequent office visits\n3 00\n(Lines 601 to 612 apply to all qualified surgeons\n481. House visit, routine, for examination and opinion\n5 00\nwith \" A rating or equivalent.)\n482. Hospital visit, for ordinary visit, dressings and\nobservation\n3 00\nDERMATOLOGY\nEYE\n\" SH \" QUALIFICATION\n\"\nSE \" QUALIFICATION\n650. Complete office examination or consultation\n10 00\n525. Simple, office, eye check-up on referred patients,\n650a. Check-up office examination of referred patient\n5 00\nmere observation (no refraction, no study of\n651. Subsequent office examination or care\n3 00\nretina)\n5 00\n652. Subsequent care, with X-ray therapy\n5 00\n526. Compiete office examination or consultation without\n653. Hospital visit\n3 00\nrefraction\n10 00\n654. Neo-salvarsan, plus cost of drug\n7 50\n527. Special study, special test for permanent disability\nand report.\nA. & A.\n528. Refraction alone and prescription for glasses\n7 50\nPROCTOLOGY\n529. Combined full examination (526 and 528) and re-\nfraction and prescription for glasses\n12 50\n530. Subsequent office visit\n3 00\n\" SM8 \" QUALIFICATION\n531. Hospital visits\n3 00\n535. Foreign body embedded in cornea, removal of\n5 00\n664. Complete office examination or consultation\n10 00\n536. Removal of intra-ocular foreign body\n21 days\n100 00\n665. Anal fissure, divulsion under anaesthesia\n15 00\n537. Removal of intra-orbital foreign body\n21 days\n100 00\n666. Single fistula including 3 weeks after care\n50 00\n560. Primary suture of lid wounds\n15 00\n667. Multiple fistulae including 3 weeks after care\n75 00\n561. Iridectomy\n10 days\n60 00\n668. Hemorrhoids, removal by injection, per visit\n5 00\n562. Cataract extraction\n10 days\n100 00\n669. Hemorrhoids, external, single, 2 weeks after care\n25 00\n563. Muscle operation\nA. & A.\n670. Hemorrhoids, multiple external, 2 weeks after care\n50 00\n564. Plastic lid operation\nA. & A.\n671. Hemorrhoids, internal, 2 weeks after care\n50 00\n568. Discission (needling) of cataract\n10 days\n75 00\n672. Incision of thrombosed hemorrhoid\n10 00\n569. Operation for detachment of retina\n10 days\n100 00\n673. Prolapse, anal, treatment by laparotomy including\n570. Enucleation of eyeball\n21 days\n100 00\n3 weeks after care\n150 00\n571. Evisceration of eyeball\n21 days\n100 00\n674. Rectal resection, including 4 weeks after care\n150 00\n572. Conjunctivokeratoplasty for perforating wounds of\n(Lines 66.4 to 674 apply to all qualified surgeons\neyeball\nA. & A.\nwith \" A \" rating or equivalent.)\n575. Glaucoma operation\n10 days\n100 00\n576 Operation for strabismus\nA. & A.\n577. Dacryocystectomy\n10 days\n75 00\nPHYSICAL THERAPY\n578. Chalazion operation, either dissection or incision and\ncurrettage\n15 00\n\" SM1 \" QUALIFICATION\nUROLOGY\n690. Per visit, inclusive of any and all modalities\n3 00\n(When total fees for physical therapy treatment\n\" SG \" QUALIFICATION\napproach the sum of $25.00, the physician\nshould file an additional C-4 report and re-\n600. Neo-salvarsan plus cost of drug\n7 50\nquest authorization as prescribed in Section\n601. Excision of kidney\n3 wks.\n150 00\n13-A-5.)\n16\n17\nOSTEOPATHY\nLine\nNo.\nItem\nLine\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\nURINE\n\" OP \" QUALIFICATIONS\n740. Routine chemical qualitative without micro-\nscopic\nLines Nos. 691 to 695 apply only when\n1 00\nosteopathic manipulation is included.\n741. Routine - chemical qualitative with microscopic\n2 00\n691. Examination or consultation at office - - first visit\n4 00\n742. Routine — chemical and microscopic including\nquantitative sugar\n692. Subsequent office visits\n3 00\n3 00\n4 00\n743. Arsenic or lead (heavy metals)\n693. Home call - day\nA. & A.\n744. Quantitative urea\n694. Home call - night (between 12 midnight and\n2 00\n745. Quantitative creatinine\n7 a.m.)\n5 00\n2 00\n746. Quantitative uric acid\n695. Hospital call\n3 00\n2 00\n747. Quantitative ammonia\n696. As respects all other items in this schedule\n2 00\n748. Quantitative chlorides\nwhich come lawfully within the scope of\n2 00\n749. Quantitative total nitrogen\nosteopathy, osteopaths shall be entitled\n2 00\n750. Above five tests\nto the same fees as permitted for physi-\n10 00\n751. Phthalein\ncians practising in other fields of\n2 00\n752. Urobilin quantitative\nmedicine.\n3 00\n753. Tyrosin\n3 00\n754. Mosenthal or other conc. tests\n5 00\nPATHOLOGY\n755. Simple culture\n5 00\n756. Special culture\nBLOOD\nA. & A.\n757. Ureter specimens, urea, microscopic plus cultures,\nboth sides\n700. Wassermann\n5 00\n15 00\n758. Tuberculosis - extra\n701. Wassermann - any modifications\n5 00\n3 00\n759. Animal Inoculation\n702. Precipitation (Kabn or other precipitation test)\n3 00\n10 00\n703. Any two tests of the above\n7 50\n704. Complement fixation gonococcus\n3 00\nCEREBROSPINAL FLUID\n705. Full blood count\n5 00\n765. Wassermann\n706. White blood count and differential\n2 00\n5 00\n766. Precipitation\n707. Coagulation time\n2 00\n3 00\n767. Colloidal Gold Test\n708. Sedimentation test\n3 00\n3 00\n768. Cell Count\n709. Fragility test\n3 00\n2 00\n769. Globulin\n710. Platelet count\n2 00\n2 00\n770. Simple culture\n711. Full test hemorrhagic diathesia\n10 00\n5 00\n2 00\n771. Special culture\n712. Icteric index\nA. & A.\n772. Smear for Bacteria\n713. Special culture\nA. & A.\n2 00\n773. Tubercle Bacilli\n714. Widal\n3 00\n3 00\n774. Twelve hour sedimentation test\n715. Simple culture\n5 00\n5 00\n716. Bilirubin VandenBergh\n3 00\n775. Full spinal fluid examination for syphilis (Wasser-\n717. Malaria (plus red blood count)\n2 00\nmann-Colloidal Gold-Cells-Globulin)\n7 50\n776. Animal inoculation\n718. Typing and grouping\n5 00\n10 00\n777. Tissue examination\n719. Cross agglutination tests\n5 00\nA. & A.\n720. Additional per person\n2 00\n721. Urea nitrogen\n2 00\nFROZEN SECTION\n722. Non-protein nitrogen\n2 00\n723. Uric acid\n3 00\n781. Frozen section, in hospital (pathologist at operation).\n15 00\n724. Cholesterin\n3 00\n782. Frozen section, outside\nA. & A.\n725. Creatinine\n3 00\n726. Sugar\n2 00\nMISCELLANEOUS ITEMS\n727. Co2\n2 00\n790. Throat culture\n3 00\n728. Any four tests of the above\n7 50\n791. Smears - all except otherwise stated\n729. Calcium\n3 00\n2 00\n792. Search for bacilli in exudates\n730. Magnesium\n3 00\n3 00\n793. Sputum for tubercle bacilli\n3 00\n3 00\n731. Phosphorus\n794. Simple sputum culture\n732. Chlorides\n3 00\n5 00\n795. Special sputum culture\nA. & A\n733. Any three of the above\n7 50\n796. Sputum microscopic\n3 00\n2 00\n734. Lactic acid\n797. Vaccines sputum\n3 00\n7 50\n735. Hydrogen ion concentration\n798. Typing of pneumococcus\n5 00\n736. Albumin-gobulin ratio\n7 50\n799. Dark field no charge for smear, venereal, etc\n5 00\n18\n19\nLine\nLine\nNo.\nItem\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\n800. Stomach contents for ferments\n5 00\n801. Ewald or retention\n5 00\n852. Fees are for a competent diagnosis by x-ray\n802. Fractional Rehfus\n5 00\nimage, expert interpretation and opinion\n803. Bacteriophags\nA. & A.\n- size and number of films not relevant.\n804. Calculi\nA. & A.\n853. Single finger\n5 00\n854. Single toe\n5 00\n855. Hand (including fingers)\n8 00\nFECES\n856. Wrist (including carpus and lower one-third of\n810. Parasites\n3 00\nforearm)\n8 00\n5 00\n857. Forearm mid one-third\n811. Typhoid and para cultures\n8 00\n812. Microscopic for bacteria, etc\n3 00\n858. Elbow (including upper one-third of forearm and\n813. Urobilin\n3 00\nsupracondyles)\n8 00\n859. Humerus mid one-third\n814. Urobilin quantitative\n5 00\n8 00\n815. Histamine\n3 00\n860. Foot (including toes)\n8 00\n816. Occult blood only\n2 00\n861. Ankle (including lower three inches of leg)\n8 00\n817. Ferments\n5 00\n862. Leg, mid one-third\n8 00\n818. Simple culture\n5 00\n863. Knee (including four inches above and below joint)\n8 00\nA. & A.\n864. Femur mid one-third\n819. Special culure\n8 00\n820. Fats - quantitative\n5 00\n865. Femur upper one-third\n8 00\n870. Shoulder joint\n10 00\n871. Clavicle\n10 00\nSPECIAL PROCEDURES\n872. Scapula\n10 00\n821. Basal metabolism\n10 00\n873. Hip joint\n15 00\n822. Immunology and allergy\nA. & A.\n875. Head and face, complete examination\n20 00\n823. Spinal puncture\n10 00\n876. Head and face, partial examination for follow-up\n824. Spinal puncture with manometric determination\n15 00\nwhen area of injury has been demonstrated\npreviously\n10 00\n830. Complete post mortem and report, without micro-\nscopic work\n50 00\n880. Nasal bones\n10 00\n881. Nasal sinuses\n831. Complete post mortem and report, with tissue micro-\n15 00\nscopic examination\n75 00\n882. Mastoids\n15 00\n883. Mandible- - one side\n10 00\n832. Other post mortem laboratory work, as\n884. Cervical spine\n15 00\nscheduled above.\n885. Dorsal spine\n15 00\n835. When pathologist visits patienťs home\n886. Lumbar spine\n15 00\nor other place to obtain specimen, add\n887. Pelvis\n15 00\n$3.00 for home visit to the above items.\n888. Sacro-iliac joint and coccyx\n15 00\n836. The attending physician will not make\n889. Any two spinal regions\n25 00\ncharge for obtaining specimen, except\n890. Any three spinal regions\n35 00\nspinal puncture.\n891. Sacro-iliac (including lumbo-sacral facets)\nA. & A.\n900. Thoracic cage (not including spine) any one area\n15 00\nROENTGENOLOGY AND RADIOLOGY\n901. Lungs and heart (not including cardiac mensura-\ntion)\n15 00\n\"\n902. Cardiac mensuration (including fluoroscopy)\n15 00\nSD\n\" QUALIFICATION\n903. Abdomen and gastrointestinal; flat plate for acute\n850. Lines 850 to 945 inclusive specify fees for\nobstruction\n15 00\nphysicians who are qualified as \" SD.\n904. Oesophagus only (including fluoroscopy)\n15 00\n851. (Instructions: Do not file either C-104\n905. Gastro-intestinal (oesophagus to cecum)\n25 00\nor C-4 reports. Instead, make writ-\n906. Gastro-intestinal (oesophagus to ampulla)\n35 00\nten report in quadruplicate; having one\n907. Colon by opaque enema\n20 00\nnotarized and sent to the district office\n908. Gall bladder, simple\n15 00\nof the State Department of Labor; send\n909. Gall bladder, Graham test, oral\n25 00\none to the attending physician or sur-\n909a. Intravenous or Stewart Concentrate\n35 00\ngeon; retain one for record. Render\n910. Genito-urinary- - simple\n15 00\nseparate bill to carrier, if known, or\n911. Genito-urinary - retrograde pylography (not in-\nemployer with the report. Films shall be\nclusive of injection)\n15 00\npreserved by roentgenologist and they\n912. Genito-urinary - pylography by excretion\n25 00\n(or satisfactory prints) shall be made\n913. Teeth - complete dental study\n10 00\navailable to attending physician, carrier\n914. Foreign body; same as part involved\nor employer.)\n915. Foreign body - search of respiratory or alimentary\ncanal\n20 00\n20\n21\nLine\nLine\nNo.\nItem\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\n916. Foreign body - eye, precise localization\n25 00\n1101. Lungs and heart (not including cardiac mensura-\n917. Foreign body - eye, without precise localization\n15 00\ntion)\n7 50\n918. Bedside - institutional - add 15% to normal fee\n1102. Cardiac mensuration, including fluoroscopy\n7 50\nfor part\n1103. Abdomen and gastrointestinal; flat plate for acute\n919. Bedside - domicile\nA. & A.\nobstruction\n7 50\n920. Interpretation of films made elsewhere\nA. & A.\n1105. Gastro-intestinal (oesophagus to cecum)\n12 50\n935. Radium therapy\nA. & A.\n1106. Gastro-intestinal (oesophagus to ampulla)\n17 50\n940. X-ray therapy\nA. & A.\n1108. Gall bladder, simple\n7 50\n945. When patients are treated by x-ray or\n1110. Genito-urinary, simple\n7 50\nradium C-104 and C-4 must be filed.\n1111. Genito-urinary, retrograde pylography (not inclusive\nof injection)\n7 50\n1113. Foreign body, same fees as No. 1053 to 1075\nX-RAY DEMONSTRATION BY SPECIALISTS OTHER THAN\naccording to region.\nTHOSE HAVING \" SD \" QUALIFICATION\n1114. Foreign body, search of respiratory or alimentary\ncanal\n10 00\n1050. Lines 1050 to 1150 inclusive apply to special-\n1116. Foreign body - eye, precise localization\n12 50\nists other than those having S.D.\"\n1118. Bedside, domicile\nA. & A.\nqualifications; each specialist limited to\n1119. Colon by opaque enema\n8 00\nhis own special field, but shall not be\n(Lines 1120-1150 are blank.)\nbarred from examining patients referred\nfor x-ray examination only in his own\nspecial field.\nX-RAY DEMONSTRATION BY PHYSICIANS WITH \" XD \"\n1051. Teeth - Complete dental study\n5 00\nQUALIFICATION\n1053. Single finger\n2 50\n1054. Single toe\n2 50\n1200. Lines Nos. 1200 to 1300 inclusive apply to\n1055. Hand (including fingers)\n4 00\nphysicians with the \" X.D.\" qualifica-\n1056. Wrist (including carpus and lower one-third of\ncation. Nothing in this schedule shall\nforearm)\n4 00\nbar such physicians from examining\n1057. Forearm, mid one-third\n4 00\npatients referred for x-ray examination\n1058. Elbow (including upper one-third of forearm and\nonly as respects to lines 1200 to 1300.\nsupracondyles)\n4 00\n1201. Fees are for regional examination, size and\n1059. Humerus, mid one-third\n4 00\nnumber of films not relevant\n1060. Foot (including toes)\n4 00\n1202. Single finger\n3 50\n1061. Ankle (including lower three inches of leg)\n4 00\n1203. Single toe\n3 50\n1062. Leg, mid one-third\n4 00\n1204. Hand (including fingers)\n6 00\n1063. Knee (including four inches above and below joint)\n4 00\n1205. Wrist (including carpus and lower one-third fore-\n1064. Femur, mid one-third\n4 00\narm)\n6 00\n1065. Femur, upper one-third\n4 00\n1206. Forearm mid one-third\n6 00\n1070. Shoulder joint\n5 00\n1207. Elbow (including upper one-third of forearm and\n1071. Clavicle\n5 00\nsupracondylos)\n6 00\n1072. Scapula\n5 00\n1208. Humerus mid one-third\n6 00\n1073. Hip joint\n7 50\n1209. Foot (including toes)\n6 00\n1075. Head and face, complete examination\n10 00\n1210. Ankle (including lower three inches of leg)\n6 00\n1076. Head and face, partial examination for follow-up\n1211. Leg mid one-third\n6 00\nwhen area of injury has been demonstrated pre-\n1212. Knee (including four inches above and below joint)\n6 00\nviously\n5 00\n1213. Femur mid one-third\n6 00\n1080. Nasal bones\n5 00\n1214. Femur upper one-third\n6 00\n1081. Nasal sinuses\n7 50\n1215. Shoulder joint\n8 00\n1082. Mastoids\n7 50\n1216. Clavicle\n8 00\n1083. Mandible, one side\n5 00\n1217. Scapula\n8 00\n1084. Cervical spine\n7 50\n1218. Hip joint\n11 00\n1085. Dorsal spine\n7 50\n1219. Head and face, complete examination\n15 00\n1086. Lumbar spine\n7 50\n1220. Head and face, partial examination for follow-up\n1087. Pelvis\n7 50\nwhen area of injury has been demonstrated pre-\n1088. Sacro-iliac joint and coccyx\n7 50\nviously\n8 00\n1089. Any two spinal regions\n12 50\n1221. Nasal bones\n8 00\n1089a. Any three spinal regions\n17 50\n1222. Nasal sinuses\n11 00\n1090. Sacro-iliac (special including lumbo-sacral facets)\nA. & A.\n1223. Mastoids\n11 00\n1100. Thoracic cage (not including spine) any one area\n7 50\n1224. Mandible - one side\n8 00\n22\n23\nLine\nNo.\nItem\nAfter-Care\nFee\nKEY TO CODE LETTERS\n1225. Cervical spine\n11 00\nX - General practice.\nL - Gynecology (1) and/or obstetrics\n1226. Dorsal spine\n11 00\nS - Practice limited to specialty.\n(2).\n1227. Lumbar spine\n11 00\nA - General surgery - major.\nM ( 1) - Physical therapy.\n1228. Pelvis\n11 00\nB — Orthopedic surgery.\nM ( 2) - Tuberculosis and lung dis-\n1229. Sacro-iliac joint and coccyx\n11 00\nC - Traumatic surgery - not inclusive\neases.\n1230. Any two spinal regions\n18 00\nof major or open procedures\nM ( 3) - Gastroenterology.\n1231. Any three spinal regions\n26 00\nunless also qualified under A\n1232. Sacro-iliac (including lumbo-sacral facets)\nA. & A.\nM ( 4) - Cardiology.\nor B.\nM ( 5) - Minor surgery.\n1233. Thoracic cage (not including spine) any one area\n11 00\nD - Roentgenology (1) and/or radia-\nM ( 6) - Anaesthesia.\n1234. Lungs and heart (not including cardiac mensura-\ntion (2).\nM ( 7) - Plastic surgery.\ntion)\n11 00\nE - Ophthalmology.\nM ( 8) - Proctology.\n1235. Cardiac mensuration (including fluoroscopy)\n11 00\nF - Laryngology (1), rhinology (2),\nM ( 9) - Neuro surgery.\n1236. Abdomen and gastrointestinal; flal plate for acute\notology (3).\nM (10) - Public health and industrial\nobstruction\n11 00\nG - Urology.\ndiseases.\n1237. Oesophagus only (including fluoroscopy)\n11 00\nH - Dermatology (1) and/or syphilo-\nM (11) - Metabolic diseases.\n1238. Gastro-intestinal (oesophagus to cocum)\n18 00\nlogy (2).\nM (12) - Immunology and allergy.\n1239. Gastro-intestinal (oesophagus to ampulla)\n26 00\nI - Neurology (1) and/or psychiatry\nM (13) - Bronchoscopy.\n1240. Colon by opaque enema\n15 00\n(2).\n11 00\nM (14) - Endocrinology.\n1241. Gall bladder, simple\nJ - Internal medicine.\nM (15) - Oral surgery.\n1242. Gall bladder, Graham test, oral\n15 00\nK - Pathology (1), clinical pathology\n1243. Intravenous or Stewart concentrate\n26 00\nM (16) - Vascular and veno-therapy.\n(2), bacteriology (3), chemistry\n1244. Genito-urinary - simple\n11 00\nOP - Osteopathic physician.\n(4), serology (5), and/or hema-\n1245. Genito-urinary — retrograde pylography (not in-\ntology (6).\nclusive of injection)\n11 00\n1246. Genito-urinary - pylography by excretion\n18 00\n1247. Teeth, complete dental study\n8 00\n1248. Foreign body, same as part involved\n1249. Foreign body, search of respiratory or alimentary\ncanal\n15 00\n1250. Foreign body - eye, precise localization\n18 00\n1251. Bedside- - institutional - - add 15 per cent to normal\nfee for part.\n1252. Bedside - domicile\nA. & A.\n1253. Interpretation of films made elsewhere\nA. & A.\n1254. Radium therapy\nA. & A.\n1255. X-ray therapy\nA. & A.\n1256. When patients are treated by x-ray or\nradium C-104 and C-4 must be filed.\n(Lines 1257-1300 are blank.)\n25\ncompensation medical bureau or laboratory under the Rules and Pro-\nRULES AND REGULATIONS\ncedure prescribed by the Industrial Commissioner as follows:\n(a) The physician or medical bureau accused of misconduct shall be\nPromulgated by the Industrial Commissioner covering Chapters\ngiven twenty days notice of the charges in writing including a\nbill of particulars setting forth the specific Section and Subdivision\n258 and 930 of the Laws of 1935 amending the Workmen's\nof the Law violated, and the time, date and place of the hearing.\nCompensation Law\n(b) Careful records and minutes shall be kept of the hearing.\n\"§ 10-a. Industrial Council\n*\n(c) These records, together with the report of the Board of the Medi-\n\"4. The Council shall (a) consider all matters submitted to it by the\ncal Society or other Board, with its findings shall be submitted\nIndustrial Commissioner and advise him with respect thereto; (b) on its\nto the Commissioner.\nown initiative recommend to the Commissioner such changes of adminis-\nAppeals filed by physicians and medical bureaus with the Industrial Coun-\ntration as, after consideration, may be deemed important and necessary\ncil shall be referred to the subcommittee designated by the Industrial\n; (d) consider all matters connected with the practice of medi-\nCouncil to ascertain the facts and report its findings to the Council for\ncine submitted to it by the Commissioner or the Industrial Board; (e)\nfinal action.\nconsider the qualifications for, or persons being considered for appoint-\n(a) A physician or medical bureau may file an appeal with the Indus-\nment by the Commissioner to positions directly involving the practice of\ntrial Council from the decision of the Medical Society or other\nmedicine, and advise the Commissioner regarding the fitness of such per-\nBoard.\nsons for appointment; (f) prescribe rules and regulations to govern the\nprocedure of investigations and hearings by Medical Societies or Boards\n(b) A physician or medical bureau appealing and the Medical Society\nof charges against authorized physicians and licensed compensation\nor other Board whose decision was appealed from, shall be notified\nmedical bureaus as provided in Section 13-d of the Workmen's Compensa-\nin writing indicating the time, date and place of hearing.\ntion Law; (g) investigate on its own initiative charges made by a physi-\n(c) The physician or medical bureau may be represented by counsel.\ncian that he has been improperly refused authorization to do compensation\n(d) Accurate stenographic or stenotype minutes of the hearing shall\nwork by a Medical Society or Board, or by the Commissioner and, if it\nbe kept for the file of the Commissioner and Industrial Council.\nsustain the charges, recommend such authorization to the Commissioner;\n(h) on its own initiative investigate and pass on charges of misconduct\n3. When a physician, in association or in co-partnership with another\nby either a physician or a compensation bureau authorized to treat injured\nphysician or physicians, or through another physician or physicians\nworkmen under this chapter; (i) review the determination of charges of\nas employees or agents, maintains and operates one or more offices prin-\ncipally for the treatment of injured claimants under the Workmen's\nmisconduct where the physician accused appeals from the decision of the\nMedical Society or Board which took jurisdiction in the first instance.\nCompensation Act, he shall apply for a compensation medical bureau\nlicense.\nIn such cases the Council may reopen the matter and receive further evi-\ndence. And the decision and recommendation of the Council shall be final,\n4. All reports, except Form C-104 filed by attending physicians and specialists\nbinding and conclusive upon the Industrial Commissioner.\nmust be verified before a Notary Public or a Commissioner of Deeds, to\n\"5. The Council shall adopt Rules and Regulations to govern its own\ninsure their value as prima facie evidence in a compensation case.\nproceedings. The Secretary shall keep a complete record of all its pro-\n5. All specialists and consultants shall submit a report of their findings\nceedings which shall show the names of the members present at each\nin triplicate, one copy to the Industrial Commissioner, one to the attend-\nmeeting and every matter submitted to the Council by the Commissioner\ning physician and one copy to the employer or insurance carrier. If a\nand the action of the Council thereon. The record shall be filed in the\nspecialist acts as attending physician, he shall file a 48 hour and C-4\noffice of the Department. All records and other documents of the Depart-\nreports with the employer or carrier and with the Industrial Commissioner.\nment shall be subject to inspection by the members of the Council.\"\nChapter 258, Laws of 1935.\n6. All medical reports filed by attending physicians and specialists must\ncontain the authorization certificate number and code letters.\n7. When it is necessary for the attending physician to engage the services\nof a specialist, consultant or a surgeon, or to provide for physiotherapeutic\n1. Medical Compensation Boards shall pass upon the applications of physi-\nprocedures, costing more than twenty-five dollars, or to provide for x-ray\ncians within a reasonable time and notify the Industrial Commissioner\nexaminations or special diagnostic laboratory tests costing more than\nof their action. If any such Board fails to recommend that a physician\nten dollars, he must secure authorization from the employer or insurance\nbe authorized to render medical care under Chapter 258 the physician\ncarrier or the Industrial Commissioner.\nmay appeal to the Industrial Council as provided in clause (G) of Sub-\nE. G.-When the total fees for physiotherapeutic treatment approach\ndivision 4 of Section 10-A of the Labor Law, and the Council thereafter\nthe sum of $25.00 the physician shall file an additional C-4 report and\nwill have sole jurisdiction.\nrequest authorization as prescribed in Section 13-a-5.\n2. Removal of physicians from panels and revocation of licenses of medical\nThis Rule also applies to hospitals, specialists, consultants and surgeons,\nbureaus. Section 13-d.\nwho are actually engaged to perform such services.\nThe recommending Compensation Board or the Board of the County\nIf telephone request for such authorization is made, it should be con-\nMedical Society in a County where any authorized physician has removed\nfirmed by letter. If such authorization is not forthcoming or is not\nhis office, shall investigate, hear and determine all charges of professional\ndenied within five working days, or if such denial is not justified\nor other misconduct by any authorized physician or by any licensed\nmedically or otherwise, the special services required for the patient's\nwelfare should be proceeded with on the ground that authorization has\n[24]\nbeen unreasonably withheld.\n27\n26\n18. No license is required for an employer to operate a first aid station\nSuch authorization is not required in an emergency under the provisions\nof Section 13-A-5.\nfor emergency treatment, but no subsequent treatments are to be rendered\nby any one, other than a qualified physician on the Minimum Fee Schedule\n8. The authority of an employer for the services of a specialist in excess\nbasis.\nof a $25.00 fee, applies only to the necessity for such services, but the\n19. No advertising matter of any nature on compensation work, by or on\nchoice of such specialist is entirely within the jurisdiction of the injured\nbehalf of authorized physicians, medical bureaus or laboratories shall be\nworker.\npermitted.\n9. When it is in the interest of the injured employee, and where an x-ray\n20. No insurance company or self-insurer may reduce the size of NOTICE\nis required and it is impossible to secure the services of a qualified\nTO EMPLOYEES (FORM C-105) which is to be posted in all places\nx-ray specialist, the Board of the local County Medical Society may\nof employment covered by the Act, unless such permission is granted on\ndesignate a specially qualified individual to take x-ray pictures under\napplication to the Industrial Commissioner.\nthe supervision of the attending physician. The attending physician,\nhowever, shall render a bill for such service to the employer. This in\n21. A physician who testifies at hearings or examines claimants or partici-\nno way, however, deprives the employer or insurance carrier from having\npates in examinations for evidential material for compensation case\nother x-ray pictures taken if they so desire.\nhearing purposes only, may accept fees for such services from claimants,\n10. A physician authorized to treat workmen's compensation cases, when\nemployers or carriers.\nrequested to supersede another physician, must, before beginning treat-\n22. Hospitals shall render bills for board and room accommodations, medical\nment of such patient, make reasonable effort to communicate with the\nand surgical supplies and nursing facilities.\nattending physician to ascertain the patient's condition. The superseding\nHospitals may render bills for x-ray, physiotherapeutic, anaesthesia and\nphysician must also advise the attending physician of the name of the\npathologic services when rendered by or under the supervision of salaried\nperson who has requested him to assume care of the case and state the\nphysicians on the staff.\nreason therefor. If the second physician cannot contact the attending\nThe names and qualifications of all physicians and persons rendering\nphysician, and the claimant's condition requires immediate treatment,\nservices for which charges are made by hospitals must be included in all\nthe said physician should advise the doctor previously in attendance\nbills and all medical and x-ray reports shall be promptly filed with the\nwithin 48 hours that he now has the patient in his care. The preceding\nemployer or its insurance carrier and the Department of Labor.\nphysician shall supply the succeeding physician with a complete history\nof the case and all pertinent medical data.\n11. In the event of a serious accident requiring immediate emergency medical\nRules Governing Recommending of Authorized Physicians\naid, an ambulance or any physician may be called to give first aid\nby Insurance Carriers and Employers and the Procedure\ntreatment.\nto be Followed by Medical Inspectors and Consultants\n12. A registered physiotherapist may treat workmen's compensation cases at\nhis own office or bureau when the case is referred to him by an authorized\n23. The supplying of names of authorized physicians by insurance carriers\nphysician. The authorized physician should, however, give written\nto their policyholders is in contravention to Section 13, as amended by\ndirections to the physiotherapist as to the kind of treatment to be\nChapter 258 of the Laws of 1935. Such policyholders and all employers\nrendered and the number of treatments to be given. These directions\nmay secure a list of all authorized physicians in the vicinity of their\nmust be given in writing by the physician and shall constitute a part\nplaces of business by applying to the Industrial Commissioner of the\nof the record of the case.\nDepartment of Labor.\n13. Bills for x-rays and consultations shall be submitted for payment\n24. Any physician who acts in the capacity of medical inspector for an\ndirectly to the employer or carrier by the specialist rendering the service.\ninsurance carrier or employer in the case of an injured employee under\nThese services must be authorized in writing by the physician in\nthe care of another physician shall not participate in the treatment of\nattendance.\nsaid injured employee except in the operation of a rehabilitation clinic or\n14. Physicians treating claimants in hospitals may secure the signature of\nbureau under Section 13-j of the Law. Nothing herein contained affects\nclaimant for authorization to obtain copies of any necessary hospital\nthe right of transfer as provided in Section 13-a (3).\nrecords.\n25. When a medical examination is had under Section 13-a (4) it shall\n15. The physician in attendance in public hospitals must be the judge as to\nbe by a qualified physician at a place reasonably convenient to the\nwhen the \"emergency status\" of the case has terminated. In case of a\nclaimant and in the presence of the claimant's physician, if in the latter's\ndispute the matter shall be referred to the Compensation Board of the\nopinion his presence is necessary. A duplicate copy of all notices of\nMedical Society of the County in which the hospital is located, for\nrequests for examinations must be sent to the attending physician.\nimmediate decision.\n26. No physician designated by an insurance carrier or an employer as a\n16. Medical inspectors of insurance companies shall be admitted to hospitals\nconsultant in the case of an injured employee, shall subsequently par-\nor other institutions where injured employees are confined, upon proper\nticipate in the medical or surgical care of said injured employee, except\nidentification, for the purpose of complying with Section 13-j.\nwith the written consent of the injured employee and his attending\nphysician. Nothing herein contained affects the right of transfer as\n17. Hospitals and dispensaries shall not operate a medical bureau or clinic\nprovided in Section 13-a (3).\nfor the purpose of rendering medical care and treatment to compensation\ncases. Hospitals and dispensaries shall not render medical care and\ntreatment to ambulatory compensation cases except for the emergency\ntreatment.\n28\nRules Governing the Licensing of and Operation of\nCompensation Medical Bureaus\n27. The character and frequency of accidents, the number of employees in\na given plant and the availability of qualified medical care in the imme-\ndiate vicinity of the place of employment should be considered in relation\nto the authorization of an employer's compensation medical bureau.\n28. The bureau should be located in the industrial plant or in the immediate\nvicinity.\n29. The question of the necessity of the presence of a physician during work-\ning hours, or the availability of a physician at stated hours should be\ndetermined by an inspection of the plant to ascertain the nature of the\nhazards and the frequency of accidents.\n30. The bureau shall be well housed with sufficient space, light and air and\nshall conform to reasonable sanitary requirements. Proper facilities in\nthe form of personnel for assistance in emergencies, instruments, steril-\nizers, dressings, drugs, shall be available at all times and in amounts\nproportionate to the size of the plant and the number of employees. Such\nfacilities shall be adequate for more than mere emergency care and for\nthe more severe type of industrial injury.\n31. A bureau license may be given for a stated project which, because of the\nhazards of the project and the frequency of accidents, requires continued\nmedical care and such license shall be for the life of the given project\nonly. In such cases all employees of all subcontractors shall be covered\nby the license.\n32. No license shall be issued to an employer to cover any but his own\nemployees except as indicated in Rule No. 31.\n33. First aid stations-No license is required to operate a first aid station\nby an employer of labor. Such first aid or emergency station should be\nproperly equipped for first aid in accordance with the type of hazard\nencountered at the particular place of employment.\n34. Form C-105, a notice of the rights of an injured employee and the\nresponsibilities of the employer, shall be posted in each compensation\nmedical bureau and first aid station.\n35. All compensation medical bureaus when operated by summer camps\nand other institutions, wherein such camps and institutions are operating\nfor profit, shall be charged a license fee of $25.00 per annum for the\noperation of such medical bureaus which are in operation for six months\nof the year or less.\nFRIEDA S. MILLER,\nIndustrial Commissioner\nMarch 1, 1939"
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