• new-changes-to-new-york-state-workers-compensation-fee-schedule

    New Changes to the New York State Workers’ Compensation Fee Schedule

    Medical providers may soon see an increase in reimbursement. Here’s what that means for you.

    By Matt Banks

    April 2019 Update: The NYS Workers’ Compensation Board recently released an update to its Medical Fee Schedule. The update increases reimbursement to providers treating WC patients.

    The rates for reimbursement have essentially remained unchanged since 1996, with rates remaining well below the rate of inflation. The new methodology for calculating these fees remains unchanged and fee schedules are both region and activity-specific. The revised fee schedule includes an overall 5% increase for all provider types and additional increases for certain specialty groups to raise the number of authorized providers for injured workers. The proposed fee schedule affects medical, podiatry, psychological and chiropractic treatment.

    While this may increase the medical costs of WC claims, the increased rates would incentivize medical professionals to provide care for work-related injuries. The main goal of the rate increase is to ensure NY providers receive fair and reasonable reimbursement for prompt, quality treatment to our injured workers. Regions with shortages of medical providers authorized to treat injured workers may see further increases to raise accessibility.

    The changes were implemented on April 1, 2019.


    Matt Banks is a Senior Risk Management Claim Representative at OneGroup. He can be reached at 315-558-6790 or MBanks@OneGroup.com.