The Minnesota workers' comp fee schedule is a limitation on the fees charged by health care providers for services and supplies rendered to injured employees.
Virtually all health care services and supplies are assigned a billing code. Since a health care provider may only perform services within his or her scope of practice, s/he may only use certain billing codes.
Every billing code is assigned several Relative Value Units (RVUs), numeric assessments of its worth compared to all other health care services, articles, and supplies. RVUs are reviewed and modified every few years by the Department of Labor and Industry (DLI).
RVUs are multiplied by a Conversion Factor (CF), a dollar value established by DLI. A separate CF is established for medical/surgical services, pathology/laboratory services, physical medicine/rehabilita- tion services, and chiropractic services. In the fall of each year, DLI establishes a new CF, which may be higher or lower than the previous year, for each of the health care services. . In general, the product of (RVU) x (CF) equals the gross dollars paid to the health care provider for the particular service rendered. For example:
An injured employee received an initial examination by a physician in an outpatient clinical setting. The billing code is 99201. Assume RVUs for this code is .84. It is is multiplied by $81.63 (the CF
presently in effect for medical/surgical procedures). Thus, the maximum fee paid to the physician for this particular service, excluding any adjustments, is $68.57.
However, net payment for any given service will depend on whether it is subject to an adjustment. That is, whether the service was performed by
a professional or technician, in a hospital or clinic, during office hours or after, bundled with other codes or performed singly, and
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