Injection Service Limitations

Division of Federal Employees' Compensation (DFEC)

The Office of Workers' Compensation Programs (OWCP) has released new guidelines implementing service limitations for injection CPT codes 20550, 20551, 20552, 20553, and 20526, which goes into effect August 1, 2013.

CPT codes 20550 and 20551 will reimburse 4 encounters within a 12 month period with no additional encounters for the claimant after that year, and for the same case number.

CPT codes 20552 and 20553 will reimburse 10 encounters within a 12 month period with no additional encounters for the claimant after that year, and for the same case number.

CPT code 20526 will reimburse 3 injections within a 12 month period.