California Labor Code Section 5307.6
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California Laws > Labor Code > California Labor Code Section 5307.6
5307.6. (a) The administrative director shall adopt and revise a
fee schedule for medical-legal expenses as defined by Section 4620,
which shall be prima facie evidence of the reasonableness of fees
charged for medical-legal expenses at the same time he or she adopts
and revises the medical fee schedule pursuant to Section 5307.1.
The schedule shall consist of a series of procedure codes,
relative values, and a conversion factor producing fees which provide
remuneration to physicians performing medical-legal evaluations at a
level equivalent to that provided to physicians for reasonably
comparable work, and which additionally recognizes the relative
complexity of various types of evaluations, the amount of time spent
by the physician in direct contact with the patient, and the need to
prepare a written report.
(b) A provider shall not be paid fees in excess of those set forth
in the fee schedule established under this section unless the
provider provides an itemization and explanation of the fee that
shows that it is both a reasonable fee and that extraordinary
circumstances relating to the medical condition being evaluated
justify a higher fee; provided, however, that in no event shall a
provider charge in excess of his or her usual fee. The employer and
employee shall have standing to contest fees in excess of those set
forth in the fee schedule.
(c) In the event of a dispute between the provider and the
employer, employee, or carrier concerning the fees charged, the
provider may be allowed a reasonable fee for testimony if the
provider testified pursuant to the employer's or carrier's subpoena
and the judge or referee determines that the fee charged was
reasonable and justified by extraordinary circumstances.
(d) (1) No provider may request nor accept any compensation,
including, but not limited to, any kind of remuneration, discount,
rebate, refund, dividend, distribution, subsidy, or other form of
direct or indirect payment, whether in money or otherwise, from any
source for medical-legal expenses if such compensation is in addition
to the fees authorized by this section. In addition to being subject
to discipline pursuant to the provisions of subdivision (k) of
Section 139.2, any provider violating this subdivision is subject to
disciplinary action by the appropriate licensing board.
(2) This subdivision does not apply to medical-legal expenses for
which the administrative director has not adopted a fee schedule.
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Last modified: March 17, 2014