When does the latest New York WCB Medical Fee Schedule take effect? What are the changes to the current New York WCB Medical Fee Schedule?
The latest New York WCB Medical Fee Schedule took effect on October 1, 2020, for purposes of no-fault claims. The latest Fee Schedule only applies to health services provided on or after October 1, 2020. If a claim contains dates of service which are both prior to and after October 1, 2020, the portion of the claim incurred prior to that date will not be subject to the amendment.
The new WCB Medical Fee Schedule has new rates for many codes, as the RVU amounts and conversion factors have changed. Overall, the new rates provide a 5 percent increase in reimbursement.
The latest Fee Schedule also has these changes:
- Chiropractors may no longer bill outside their section. As a result, Manipulation Under Anesthesia (MUA) performed by chiropractors will no longer be reimbursed. CPT codes for electrodiagnostic testing contained within the chiropractic section will still be billable at a reduced rate of reimbursement.
- As of October 1, 2020, range of motion testing, muscle testing, unlisted neurological testing and physical performance testing (in the Chiropractic fee schedule), will not be reimbursed for any provider.
- Imaging studies taken within seven days of the first imaging study and related to the injury or problem necessitating the first imaging study, and which could have been reasonably performed at one time, will be subject to reduction.
The Workers’ Compensation Board Press Release about the Fee Schedule can be found here.