In this LAT dispute, the insurer challenged the length and hourly rates claimed in one of the claimant’s treatment plans. The claimant was seeking $1,466.25 in remaining amounts for psychological treatment. The plan consisted of twelve one and a half hour sessions at the hourly rate of $224.42. Dr. Harris’ psychological report, which formed the basis of the disputed OCF-18 form, had recommended that the claimant receive twelve sessions but had not specified their length. The insurer argued that the claimant should only be entitled to twelve one-hour sessions, which were limited to the hourly rate of $149.61 pursuant to the FSCO Professional Services Guideline. Adjudicator Deol agreed that treatment fees should not exceed the FSCO limits and upheld the denial of the remaining treatment balance.
