Allstate Indemnity Company v. Gady Abramson, D.C., P.A.
A chiropractic provider billed aqua therapy under generic CPT code 97039 and sought PIP reimbursement at the rate for analogous listed modalities; Allstate instead limited payment to 80% of the workers' compensation maximum allowance because aqua therapy did not appear on the CY 2019 participating physicians fee schedule of Medicare Part B. The Third District reversed summary judgment for the provider, holding section 627.736(5)(a)(1)(f), Florida Statutes (2019), permits an insurer to resort to the workers' compensation schedule when a non-ambulatory, non-clinical-laboratory service is not listed on the participating physicians fee schedule.
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