A. Professional and HCPCS Fee Schedule Creation. Update a Professional and Healthcare Common Procedure Coding System fee schedule for two Geozips in Delaware which shall establish the maximum allowable payment for services for the categories: Professional services (Anesthesia, Evaluation and Management, Surgery, Radiology, Laboratory and Medicine) and HCPCS. The creation shall consist of the final methodology/schedule adopted by the Department of Labor and does not include the research and analysis in working with the Agency. Worker’s Compensation Oversight Panel and other entities (DCRB, actuaries, etc.) The vendor will also incorporate its Essential RBRVS product in valuing new procedure code using generated conversion factors that are approved by Agency. Will also provide a final iteration of the Deliverable following Agency’s review of the initial Deliverable. B. Facility Fee Schedule Creation. The selected vendor agrees to update the Inpatient Hospital, Outpatient Hospital and Ambulatory surgery Center fee schedule for two Geozips in Delaware which shall establish the maximum allowable payment for services. The creation shall consist of the final methodology/schedule adopted by the Agency and does not include the research and analysis in working with the Agency. Workers’ Compensation Oversight Panel and other entities (DCRB, actuaries, etc.). The vendor will provide use to the then current Diagnosis Related Group (DRG), CPT and HCPCS codes and fees to detail the Deliverables. The vendor will incorporate generated conversion factors (base rates) that are approved by Agency. The vendor will also provide a final iteration of the Deliverables following Agency’s review of the interim Deliverable.
