by Kenneth A. David, Esq.

We previously reported on changes to the Fee Schedule effective May 1, 2014. One area that has not changed but continues to be the subject of some dispute is the cost of IMEs. Technically, there is no maximum amount a doctor can charge for an IME. The Fee Schedule allows a physician to be paid $600 for the first hour and then $150 for each 15 minutes thereafter. However, the doctor can charge for not only the exam but also records reviews.

How do you get what you need from an IME doctor without having to pay too much? First, make sure you know what the fee is before setting the IME and if there will be separate review time charges. Second, send only the records that are relevant. The records should be complete but if you have records related to an unrelated hospitalization 20 years ago, there is no need to include those. Third, get your money’s worth by following up with the doctor if you have any questions after getting the report. Generally, the higher the cost of the IME, the more likely the doctor is to speak with you at no additional charge. Fourth, get an itemization of charges so you can see what is being allocated for pre-IME review.

And there is a difference if it is your IME or the claimant’s IME. Arguing with your IME doctor about fees can have consequences.