In today’s blog post, we discuss the topic of QME doctor depositions, from a definition of QME doctors to the guidelines to bill medical testimony. Keep reading to learn more.
What Is a QME Doctor?
The term QME stands for Qualified Medical Evaluator. In California, a QME doctor is a physician certified by the Medical Unit of the Division of Workers’ Compensation (DWC) to examine injured workers in order to evaluate their disability and write medical-legal reports. The medical-legal reports prepared by QMEs are then used to determine the benefits the worker should receive.
QMEs are picked from randomly-generated lists of certified physicians. If the worker has an attorney, then the attorney and the claims administrator can agree on a doctor to resolve a medical-legal dispute. In this case, the physician is called an Agreed Medical Evaluator, or AME.
What Is a QME Doctor Deposition?
In some cases, the QME or AME may be asked to depose. Simply put, an AME or QME doctor deposition is a process where the AME or QME is questioned under oath by an attorney about the contents of a medical-legal report they prepared.
Both QMEs and AMEs can be required to depose.
The California Code of Regulations says the following about depositions:
- “Unless the Appeals Board or a Workers’ Compensation Administrative Law Judge orders otherwise or the parties agree otherwise, whenever a party is legally entitled to depose the evaluator, the evaluator shall make himself or herself available for deposition within at least one hundred twenty (120) days of the notice of deposition.”
- “Upon the request of the unrepresented injured worker and whenever consistent with Labor Code section 5710, the deposition shall be held at the location at which the evaluation examination was performed, or at a facility or office chosen by the deposing party that is not more than 20 miles from the location of the evaluation examination.”
Medical Legal Billing and QME Doctor Depositions
AME and QME doctor depositions are billed according to the Medical Legal Fee Schedule (MLFS).
Here’s what the MLFS says about the billing of medical legal testimony.
- Billing code: ML204
- “The physician shall be reimbursed at the rate of RV 7 [$455/hr], or his or her usual and customary fee, whichever is less, for each quarter hour or portion thereof, rounded to the nearest quarter hour, spent by the physician.”
- “The physician shall be entitled to fees for all itemized reasonable and necessary time spent related to the testimony, including reasonable preparation and travel time.”
- “The physician shall be paid a minimum of two hours for a deposition.”
- “If a deposition is canceled fewer than eight (8) calendar days before the scheduled deposition date, the physician shall be paid a minimum of one hour for the scheduled deposition.”
Practice IQ: Medical Legal Billing in California
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