Records Fees, Copying Fees
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This policy governs Moda Health's reimbursement stance for medical record copying fees and related record-provision costs for providers and applies to Moda Partners, Inc. and its subsidiaries for all provider contract statuses and claim forms.
No material clinical or coverage changes in this revision.
Reimbursement Criteria
Reimbursement Criteria for Record-Copying Fees
Rules governing reimbursement and treatment when records are requested:
Limited exceptions (individual consideration)
- On-site audit requests may be considered for separate reimbursement on an individual basis.
- Large-volume requests from a source other than the billing or rendering provider (e.g., subrogation reviews) may be considered on an individual basis.
Administrative and Billing Codes
| S9981 | Medical records copying fee, administrative |
Provider Obligations and Billing Instructions
Do not bill Moda for routine record-copying fees; S9981 denied
Do not bill Moda for routine record-copying fees. HCPCS S9981 (Medical records copying fee, administrative) is denied as a bundled provider responsibility and will not be paid; if no other services are billed for the date of service, S9981 is considered included in the services documented on those dates. If requested records are not received timely because copying fees were not paid, the records are treated as not available, services under review or audit will be denied for lack of documentation, and late submissions of records are not accepted.
- Record-copying vendors must bill the provider or facility that engaged them (providers should not forward copying charges to Moda).
- Invoices for record-copying fees or similar charges are not paid.
- Exceptions for separate reimbursement are limited (e.g., on-site audits or large-volume requests) and considered only on an individual basis.
Definitions and Acronyms
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