Call or email us anytime
(805) 484-0333
Search Guide
Today is Wednesday, April 08, 2026 -

News Articles

WCRI Says Setting Fee Schedules a Balance for States

  • National
  • Topic: NATIONAL
  • - Popular with: Legal
  • -  0 shares

Researchers with the Workers Compensation Research Institute said states seeking to adopt or update workers’ compensation fee schedules ought to consider the ramifications of setting fees too low or high, balancing cost containment and adequate care for injured workers.

Cambridge, Massachusetts-based WCRI in a report released on Tuesday showed how 44 states and the District of Columbia managed policy choices when it came to fee schedules, highlighting rates in reference to those set by the federal Medicare program. The report provides guidance for states seeking to make changes to the way insurers cover medical procedures.

“The construction of a medical fee schedule in workers' compensation involves a delicate balance,” Ramona Tanabe, WCRI’s executive vice president and counsel, said in a statement. “Setting rates too low may make treating workers uneconomical for providers and jeopardizes workers’ access to quality care. Conversely, if rates are set too high, savings will be negligible and the fee schedule will not achieve its cost-containment goal.”

On average, the District of Columbia, Florida and Massachusetts set their workers' comp fee schedule rates within 20% of Medicare rates. Alaska, Idaho, Illinois, Nevada, North Dakota and Virginia set fee schedule rates at levels more than double Medicare at the state level.

About one-quarter of the fee schedule states established their rates for office visits near the Medicare level or below, while about the same number of states set their fees for major surgery at triple the Medicare rates or more in each state, according to the analysis.

Business Insurance is a sister publication of WorkCompCentral. More stories are here.

No Comments

Log in to post a comment

Close


Do not post libelous remarks. You are solely responsible for the postings you input. By posting here you agree to hold harmless and indemnify WorkCompCentral for any damages and actions your post may cause.

Advertisements

Upcoming Events

  • Apr 14-15, 2026

    FLOIR Insurance Summit 2026

    The Florida Office of Insurance Regulation (FLOIR) invites you to attend its premier Insurance Sum …

  • Apr 20-22, 2026

    The IAIABC Forum 2026

    The Forum brings the workers' compensation community together to collaborate, share insights and i …

  • Apr 22-24, 2026

    36th Annual Anti-Fraud Confere

    Join us in Monterey for networking, learning and growth. Experience unparalleled opportunities f …

Workers' Compensation Events

Social Media Links


WorkCompCentral
c/o Business Insurance Holdings, Inc.
PO Box 1010
Greenwich, CT 06836
(805) 484-0333