In this 30-minute recorded webinar, Dr. Olesya Fomenko presents findings from WCRI's study, Designing Workers’ Compensation Medical Fee Schedules, 2022. The study highlights the important design choices faced in adopting, reforming, and updating a workers’ compensation medical fee schedule.

“The construction of a medical fee schedule in workers’ compensation involves a delicate balance,” said Ramona Tanabe, WCRI’s president and CEO. “Setting rates too low may make treating workers uneconomical for providers and could jeopardize 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. The design choices, which often become the center of intense policy debates, come down to decisions:

• How high or low should the fee schedule level be set?
• How frequently should fee schedules be updated (e.g., relative values, list of procedures, etc.)?
• Should the fee schedule be based on the relative value units of different professional medical services or on some other metric (e.g., historical charges or usual and customary charges)?
• If based on relative value units, should the fee schedule for physician services use the relative values developed for the Medicare program or some other relative value scale?

In addressing these different design choices, this study provides inter- and intrastate comparisons of the workers’ compensation fee schedule rates that illustrate the realization of the fee schedule design options.

Recorded webinars are $15 for non-members and FREE for WCRI members, members of the press, legislators as well as their staff, and state public officials who make policy decisions regarding workers' compensation. Attendance is limited to 500 people, and all attendees receive a copy of the slides and a recording of the webinar.

Return to listing