March 17, 2015
Area(s) of Interest:
Payor Issues and Reimbursement Practice Management Workers' Compensation
The California Department of Industrial Relations (DIR) announced that fees for submission of an Independent Medical Review (IMR) or Independent Bill Review (IBR) for workers’ compensation were reduced effective January 1, 2015.
The following table summarizes the reduction in fees.
| | Fee prior to December 31, 2014 | Fee effective January 1, 2015 |
| Independent Medical Review | | |
| Standard IMRs involving non-pharmacy claims | $420 | $390 |
| Standard IMRs involving pharmacy-only claims | $390 | $345 |
| IMRs terminated or dismissed, not forwarded to a medical professional reviewer | $160 | $123 |
| IMRs terminated or dismissed after case forwarded to a medical professional reviewer | $420 | $390 |
| Expedited IMRs involving non-pharmacy claims (no change in fee) | $515 | $515 |
| Independent Bill Review | | |
| Completed IBR | $250 | $195 |
| Terminated IBR not sent to review | $50 | $47.50 |
Physicians who submitted an IMR or IBR on or after January 1, 2015, will receive a refund for any fees paid in excess of the new fee schedule.