Three states have adopted changes to their workers’ compensation medical fee schedules for 2021.
Connecticut: Starting April 1, hospital services will be reimbursed at 174% of Medicare’s rates, the state Workers’ Compensation Commission announced. The rate for hospital outpatient surgery will be 210% of what Medicare pays, and the ambulatory surgical center rate will be 195% of Medicare’s fees.
For outpatient services for which there is no rate, parties should negotiate reimbursement, the commission noted. If negotiation is not successful, the parties can request a hearing with the commission, but treatment should proceed while the case is pending.
The commission said it is working with a vendor to publish the 2021 rates, rules and guidelines before April 1, and notice will be posted on the agency’s website.
Maryland: The Workers’ Compensation Commission published new conversion factors and percentage multiplier information for calendar year 2021. For medical services and treatment, the conversion factor will be $47.12, up from $46.42.
The commission also published new anesthesiology base units and calculations, along with orthopedic and neurological surgery Current Procedural Terminology (CPT) codes, as well as miscellaneous information, all of which became effective Friday.
Nebraska: The Workers’ Compensation Court posted the new medical services fee schedule that took effect Friday. The conversion factor for emergency room evaluation and management, for example, will be increased from $67.49 to $68.43.
The fees for inpatient hospital Diagnostic Related Groups (DRGs) and inpatient hospital trauma services will be posted within the next week, the court said.
