Top Stories:

NYSCA Formal Comments on Revised Workers' Compensation Fee Schedule

by NYSCA Insurance Committee | 11/2/2018 9:05:52 AM

NYSCA Members,

The NYSCA heard your concerns and has responded to the revised Workers Compensation Fee Schedule.  As you may be aware, the draft proposal includes a 22% increase for most services rendered by Doctors of Chiropractic.  There also is an increase in the daily RVU cap from 8 to 12 for a routine visit, and similar increases for visits with initial and re-examination.  These are some positive and needed changes.  We also had some significant concerns which were shared with the WCB.  The official public comment period ended November 1. Below are the submitted responses.

Concerns included a ‘Note’ added to the revised version of the fee schedule that lacked clarity and may have significantly impacted care for those treated after 180 days from the date of their injury, particularly in No-Fault.  NYSCA has submitted comments recommending removing that wording.

There is also concern about the disparity in conversion factors.  The conversion factor for doctors of chiropractic remains significantly less than other professionals.  Our letter, sent jointly with the Council, outlines all of the reasons for parity.  Based on the evidence, the conversion factor for chiropractic should sit between physical therapy and general practice physicians.  Continuing the historical discrepancy of lower fees for doctors of chiropractic is not acceptable and must be addressed.

Chiropractors with expertise in performing MUA also created a letter supported by the NYSCA Clinical Practice Committee to have MUA CPT codes rightfully restored to the fee schedule.  There is no reason they should not be included and we look forward to seeing them restored.  Procedures which are not recommended in the Medical Treatment Guidelines still require a fee schedule for approved variances and No Fault cases.

The electrodiagnostic community created a response supported by the NYSCA Electrodiagnostic committee outlining their concerns.  Appropriate CPT codes for these services were added to the revised fee schedule after the initial round of comments.  While this represented progress for those performing electrodiagnostics, some changes in the CPT coding across the industry led to concern from all providers of EDx services and these were brought to the WCB for careful consideration. 

NYSCA public comments:

Thank you to all who took the time to express their concerns, share their thoughts, and send us supportive evidence.  The NYSCA WC Committee will continue to work with the WCB on this issue and will update you as soon as there is news to share.  Together we can make a difference!! 

NYSCA Officers & Workers' Compensation Committee

 

Save the Date
2019 Spring Convention
March 29-31, 2019

Mohegan Sun
Mohegan
Sun
Casino & Resort
Learn More!

Subscribe to our mailing list

* indicates required