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Workers Comp Medical bill fee schedule Nonexistent In Few States


Corrected on States Without Workers Comp Medical Bill Fee Schedules

The States of Virginia Workers Comp Medical Bill Fee Schedules does not exist.  A few weeks ago, I posted a blog on the States that have no medical fee schedules. I stand corrected as I left Virginia out as a state without a fee schedule. The states without a medical fee schedule are Delaware, Indiana, Iowa, Missouri, New Hampshire, New Jersey, Virginia, and Wisconsin. This comes from an advisory memo from the CMS (Centers for Medicare and Medicaid Services)on errors made when submitting Workers Compensation Medicare Set-aside Agreements (WCMSA or MSA – more on that in a later post).

Picture of Workers Compensation Medical Bill Fee Paper and Stethoscope

I do not go back and redo corrections in the original posts. My prior blog post left out Delaware and Virginia as not having fee schedules. Virginia is one of a kind state on their Workers Comp medical fee schedules. Medical providers in Virginia bill using rates based on medical charges that prevail in the same community for similar treatment. That would make Virginia a non-fee schedule state.

However, Delaware does have a fee schedule. I am looking at it as I type this post. I will research and see why the Federal Government thinks that Delaware does not have a fee schedule.

I will post the next time on MSA’s which employers that have serious claims should be very familiar with overall. If you are reading this and you have not heard of MSA’s, please check out my next post. Employers can be hung out to dry on this part of a claim.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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