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The moment many
designated doctors have long awaited and lobbied (dare we say begged) for has
finally arrived. The Division has proposed changes to the billing and
reimbursement structure for certain workers’ compensation services that will
also benefit RME providers as well as treating and referral doctors. Who
knows, maybe the promise of greater financial incentive is responsible for the
recent bump in the number of designated doctors on the Division’s list that has
swollen from the 238 reported in March to a whopping 288 in November (all but
12 of the 50 being chiropractors).
The proposal includes adjusting fees once by applying the Medicare Economic
Index (MEI) adjustment factor for examinations performed 2009-2024; adjusting
the fees annually on January 1st by applying that factor in Section
134.203(c)(2); rounding the fees to whole dollars; creating a specialist fee of
$300.00 and including the much longed for $100.00 missed appointment fee.
The proposal also eliminates the current tiering structure so that for DD
and RME examinations, all issues addressed in one exam are paid at the
established fee and not reduced. An assignment number in the prior
authorization field of medical billing forms will be required to identify
DD-associated billing.
For more information about the proposed rule amendments, click here.
You can view the proposed changes here: Chapter 133 and Chapter 134.
A public hearing on the rules is scheduled for 11:00 a.m. on January 23,
2024.
Copyright 2024, Stone Loughlin & Swanson, LLP