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Workers comp fee schedule   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 other factors.



Medical/Surgical Services          Workers' Comp  Fee Schedule Rules
     for Medical/Surgical Procedures & Supplies

       
    Provider Responsibilities
           Procedure Codes       (Key -- Subpart 2)
           Professional/Technical Components
           Outpatient Limitation
           Fee Adjustments
                                          Excessive Charges, (Subpart 1)
                                          Uncoded Services, (Subpart 2)


Pathology/Laboratory Services               Workers' Comp Fee Schedule Rules for
          Pathology/Laboratory
Procedures & Supplies

                   
Provider Responsibilities
                    Procedure Codes    (Key -- Subpart 2)
                    Fee Adjustment
                    Excessive Charges (Subpart 1)
                    Uncoded Services (Subpart 2)



Physical Medicine/Rehabilitation services                Workers' Comp Fee Schedule Rules for
    Physical Medicine / Rehabilitation Procedures & Supplies

                 
Provider Responsibilities
                  Procedure Codes   (Key -- Subpart 2)
                  Fee Adjustments
                  Excessive Charges (Subpart 1)
                  Uncoded Services (Subpart 2)



Chiropractic services               Workers' Comp Fee Schedule Rules for
                  Chiropractic Procedures & Supplies

                         
Provider Responsibilities
                          Procedure Codes   (Key -- Subpart 2)
                          Fee Adjustments
                          Professional / Technical Components
                          Excessive Charges (Subpart 1)
                          Uncoded Services (Subpart 2)





Pharmaceutical services                     Workers' Comp Fee Schedule Rules for
                                         Pharmacies

                              
MN Rules, Part 5221.4070:

                            Subpart 1.       Substitute Generically Equivalent Drugs
                            Subpart 2.       Procedure Codes and Customary Charge
                            Subparts 3, 4.  Maximum Fee



Work comp client needing help
                           If You Need Help With Your Work Comp Injury

              Or You're a Provider Who's Considering a Parker-Lindberg Case
                                     Or a
Seminar on Workers' Comp


                                                 Give Us a Call


                                                  
612-424-4516


     Or if you prefer email ...

Workers Comp Practice Areas:
Claim Denied    Benefits Stopped    Treatment Denied    Rehabilitation Denied   3rd Party Claims    Reopen Settled Case   Litigation Process   Seminars

Workers' Comp Frequently Asked Questions:
Appeals    Attorney Fees    Change Jobs   Child Support   Disability Rating   ERISA   Family Medical Leave
Fee Schedule     First Report of Injury     Fraud     Functional Capacity Exam     Independent Medical Exam
Liens      Lump Sum     MMI      Mediation     Mental Illness      Overtime      Parker-LindbergPay     Posters
Prescriptions  PrivacyRights  Reasonable Distance   Rehabilitation Consultant (QRC)   Report of Workability
Return to Light Duty     Special Compensation Fund      Statute of Limitations      Subrogation      Surgery & Injections    Taxable    Temporary Workers   When Required   Work Hardening

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       The material presented at this site is general information only. It does not constitute legal advice,
     nor does it form, or is it intended to form, an attorney-client relationship. The information presented
     herein does not constitute medical advice and should not be substituted for competent advice from
     a  professional health provider. The information contained herein is based on the applicable laws of
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