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New fee reduction for Workers’ Compensation Independent Medical Review and Independent Bill Review submissions



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.

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