QME Fees

Medical-legal work is not priced like private consulting. California uses a medical-legal fee schedule with defined codes, so the amount payable for an evaluation follows the code that fits the work rather than an individual negotiation. That gives all parties predictability and removes fee disputes from what is already a contested process.

Amounts shown are the fee schedule figures for the codes listed. Confirm the code that applies to a particular evaluation with your coordinator before assuming a total.

ML201 includes review of up to 200 pages of records. Beyond that threshold, additional pages are billed at $3.00 per page. On document-heavy claims this component can matter as much as the base amount, which is a practical argument for sending a curated, de-duplicated file rather than everything on hand.

Duplicated records inflate the page count without adding information. Indexing the file and removing duplicates before service is one of the few reliable ways to reduce the cost of an evaluation without reducing its quality.

Where the evaluation is performed by an Agreed Medical Evaluator — an evaluator both represented sides agree upon — a modifier of 1.35× applies to the schedule amount.

Whether that premium is worth paying is a strategic question rather than a purely financial one. An evaluator both sides already accept produces an opinion that is less likely to be contested, and a single accepted report can be cheaper than a disputed one. The QME vs AME comparison sets out the wider trade-offs.

ML200 covers a missed appointment at $503.75. The financial cost is only part of the impact — a missed evaluation also delays the report and, with it, the resolution of the claim. Confirming attendance, transport, and any interpreter requirement in advance avoids the great majority of these.

ML204 is billed at $455.00 per hour. Hourly billing typically applies where the work does not fit a flat evaluation code. As with the page-count component, the amount of work reflects the volume and complexity of what is sent, so a well-prepared file keeps the total contained.

We coordinate evaluations for law firms, third-party administrators, employers, and corporate clients across California, and can confirm which codes are expected to apply once the specialty, the issues, and the record volume are known. We do not work directly with claimants. Volume arrangements are available for clients sending regular referrals.