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New workers' compensation RBRVS physician fee schedule effective January 1, 2014



December 11, 2013
Area(s) of Interest: Payor Issues and Reimbursement Workers' Compensation 

As part of the reforms instituted by SB 863, the Division of Workers’ Compensation (DWC) will begin utilizing a new fee schedule based on the resource-based relative value scale (RBRVS) effective January 1, 2014.


The new RBRVS-based physician fee schedule will apply to services rendered on or after January 1, 2014, and will replace the current Official Medical Fee Schedule, which has not been updated to reflect new procedure codes and relative value units (RVU) since 1999. This newly adopted physician fee schedule will utilize current procedure codes and relative value units and will allow for annual updates to these values.


Under the new RBRVS Physician Fee Schedule regulations (located under Physician services on DWC’s OMFS webpage), the calculations to determine maximum allowable amounts for each code will incorporate a number of factors, including the assigned RVU values for each code along with the yearly adjusted conversion factor determined by DWC. 


DWC has confirmed it will not be publishing a composite fee schedule for physicians to access.


For more information, DaisyBill is offering a four-part series of free webinars on the fee schedule changes and how to calculate the amount due with the new RBRVS fee schedule. Click here to view the on-demand webinars, and check back for webinars not yet scheduled.

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