UNITED AUTOMOBILE INSURANCE COMPANY v. LAUDERHILL MEDICAL CENTER LLC (2022)

Appellant, United Automobile Insurance Company, appeals the trial court's final order granting summary judgment in favor of appellee, Lauderhill Medical, on Lauderhill's claim for underpayment of PIP benefits. Lauderhill provided “vibe therapy”¹ to the insured and billed United Automobile under CPT code 97039, which is a non-specific code for therapy. United Automobile reimbursed Lauderhill Medical according to the lower-paid workers’ compensation fee schedule because CPT code 97039 did not have a set price under the Medicare fee schedule. The trial court held that United Automobile's reimbursement was in error because it is the nature of the service that controls, not the billed CPT code. See Allstate Fire & Cas. Ins. Co. v. Perez ex rel. Jeffrey Tedder, M.D., P.A., 111 So. 3d 960 (Fla. 2d DCA 2013). Because we have held that the plain language of section 627.736(5), Florida Statutes (2019), mandates payment under the workers’ compensation schedule only if the service is not reimbursable under Medicare Part B, and vibe therapy is a reimbursable service under Medicare Part B even though the CPT code has no set price, we affirm the trial court's order granting summary judgment in favor of Lauderhill Medical. See United Auto. Ins. Co. v. Lauderhill Med. Ctr., LLC, No. 21-2308, ––– So.3d ––––, 2022 WL 16827467 (Fla. 4th DCA Nov. 9, 2022).

Affirmed.

FOOTNOTES

1.   The expert witness affidavit defined vibe therapy as providing a massage using a “power vibe machine.” He described the machine as “a patented sonic vibration technology whole body vibration which uses vibration for maximum muscle toning and lymph drainage.”

Levine, J.

Conner and Kuntz, JJ., concur.