Designing Workers’ Compensation Medical Fee Schedules, 2022
Channel: Workers Compensation Research Institute (WCRI)
Date: 2022-06-28

As policymakers seek to implement or change price controls in their state workers’ compensation system with a fee schedule, this study highlights the important design choices faced in adopting, reforming, and updating them.

The construction of a medical fee schedule in workers’ compensation involves a delicate balance. Setting rates too low may make treating workers uneconomical for providers and jeopardizes workers’ access to quality care. Conversely, if rates are set too high, savings will be negligible and the fee schedule will not achieve its cost containment goal.

The study shows how the 44 states with fee schedules and the District of Columbia have resolved these fee schedule design choices, as of March 31, 2022. The study also includes a discussion of the substantial fee schedule changes for professional medical services since February 2019. 

For more information about this study or to purchase a copy, visit WCRI’s website at https://www.wcrinet.org/reports/designing-workers-compensation-medical-fee-schedules-2022. Olesya Fomenko and Te-Chun Liu are the authors of the study.