DWC Posts Proposed Amendments to Medical-Legal Fee Schedule to Online Forum for Public Comment

The Division of Workers’ Compensation (DWC) has posted proposed amendments to the Medical-Legal Fee Schedule to its online forum where members of the public may review and comment on the proposals. The draft regulations include:

• A single, flat fee for comprehensive ($1,650), follow-up ($1,100), and supplemental ($275) medical-legal evaluations
• Additional payment for review of medical records based upon the amount of pages reviewed
• Elimination of complexity factors
• An increase in the hourly fee for medical-legal testimony
• An increased modifier for evaluations performed by a psychiatrist or psychologist
• An increased modifier for evaluations performed in an underserved area
• Standardization of the fee that can be charged for a missed appointment.

The implementation of a predominantly fixed fee for all procedure billing codes is anticipated to reduce frictional costs by establishing reimbursement that is based on objective and quantifiable criteria. The increase in the multiplier for setting fees will increase the reimbursement for the vast majority of evaluations performed by physicians.

The forum can be found on the DWC forums webpage under “current forums.” Comments will be accepted on the forum until 5 p.m. on Friday, August 23.

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