What are the proper billing amounts for the medical services I provide?
Bills for New York physicians are reimbursed in accordance with the New York Workers’ Compensation Board (WCB) Medical Fee Schedule. New York-based Ambulatory Surgery Centers (ASCs) are reimbursed in accordance with the EAPG (Enhanced Ambulatory Patient Grouping) payment methodology.
Durable Medical Equipment providers (DME) in New York are reimbursed in accordance with the New York DME fee schedule. New Jersey physicians and ASCs are both reimbursed in accordance with the New Jersey fee schedule. If medical providers underbill for their services, that practice limits their reimbursements. The reason: providers cannot receive reimbursements that are greater than the amounts they bill.