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Medical Fee Schedule

As authorized under Idaho Administrative Rule, the Program has adopted the Crime Victims Compensation Fee Schedule for payments made on behalf of victims for treatment and services.

For all dates of service on or after July 1, 2010, the program will determine payment based on the Crime Victims Compensation Fee Schedule.  The Crime Victims Compensation Act prohibits providers from collecting any unpaid portion of the bill from the victim or claimant, unless the Program is unable to make the full allowable payment based on its laws and rules.  Providers will be advised if any portion of a claim is collectable from the victim or claimant.  If providers are advised that no portion of a claim is collectable from the victim or claimant, then the payment is considered payment in full.  Any treatment provided prior to July 1, 2010 will be processed at a 25% reduction from reasonable and customary billed charges, due to budgetary limitations.

Providers and claimants/victims will receive an Explanation of Benefits advising if any portion of a claim may be billed to the victim or claimant.

Please include the following information with your bill:

  • UB04 or CMS 1500, including CPT codes
  • Listing of payments made and by whom (Insurance payment, patient payment, Medicare, Medicaid, etc.  Please include an EOB if applicable.)
  • Medical records for each date of service

Detailed information on the Crime Victims’ Compensation Fee Schedule can be found in IDAPA 17.10.01.011.07.

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