1.6 Other Fees

(Procedure code XX-15)

The maximum fee for a canceled or missed appointment is one-half of the allowable fee for the scheduled service(s) or $150.00, whichever is less. Payment must be requested by the provider. DVR will negotiate the lowest possible cost in such circumstances.

(Procedure codes 01999-01, 01999-02, 01999-03, 01999-04, 01999-05, 01999-06, 01999-07, 01999-08)

Rates for Reproduction of In-File Records (in accordance with CRS 25-1-801)

• Pages 1 to 10 - $18.53 maximum

• Pages 11 to 40 - $.85 per page

• Pages greater than 41 - $.57 per page

• Review or edit in-file records is necessary prior to copying, if necessary - $10.50 maximum

• Narrative medical report based on in-file records - $42.00 maximum

• Records copied from microfilm - $1.50 per page

• Records provided on a CD - $25.00 or the above rates, whichever is less

• Postage - usual and customary rate