| Summer 2010
State Increases Medical Fee Guidelines
Doctors who participate in the Texas workers’ compensation system are earning more money in 2010.
Earlier this year, the Texas Department of Insurance, Division of Workers’ Compensation (DWC) adopted changes to the Medical Fee Guidelines, which on average raised payments for workers’ compensation services.
"I would think that these rate increases would cause physicians who left the workers' compensation system to take another look."
—Dr. Bernard T. Swift
Texas MedClinic, San Antonio
As a network provider, your contracted rates are, in most cases, tied directly to the Texas State Fee Schedule. While the Texas State Fee Schedule is based on the Medicare Fee Schedule, its Conversion Factor is set by the state of Texas.
As you see cuts in Medicare looming on the horizon, it is important to note that any changes to Medicare’s Conversion Factor will not affect your workers’ compensation reimbursement.
Since 2008, Texas has been increasing the Conversion Factor based on the Medicare Economic Index (MEI), which is a weighted average of price changes for goods and services used to deliver physician services.
Using the Conversion Factor for Texas, workers’ compensation medical provider services are reimbursed significantly higher than Medicare.
“I would think that these rate increases would cause physicians who left the workers’ compensation system to take another look,” said Dr. Bernard T. Swift, Founder/CEO of Texas MedClinic in San Antonio.
“I encourage my fellow Texas Star Network® physicians to tell their colleagues about the opportunities and changes going on in the workers’ compensation arena,” added Dr. Swift. For more information about the Medical Fee Guidelines, visit www.tdi.state.tx.us/bulletins/2009/cc47.html.
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