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Workers Comp Medical Fee Schedules – Are They Worth It?


Medical Fee Schedules For Workers Comp

Workers Comp medical fee schedules are they worth it for the state without one to act for their constituent employers?

Missouri, New Jersey, Wisconsin, Indiana, Iowa and Virginia all have two things in common that only these six states share.

I had written about the two things in common a few times in the past. The title does give it away.

Picture Of Medical Personnel Medical Fee Schedules Pouring Medicine From Bottle

They are the states that still do not have medical fee schedules for Workers Compensation treatment of injured employees. In 2009, I wrote this article on states without medical fee schedules. Missouri and Iowa were lower for medical costs then, but that has all changed very quickly.

I find that astounding after it has long been proven that any state without a medical fee schedule is harming businesses indirectly. The states without one were 27 – 51% higher in the cost of medical treatment.

The main similarity is they are the most expensive states for Workers Comp medical treatment according to a recently released study on medical fee schedules. The Workers Comp Research Institute (WCRI) recently released a study titled Medical Price Index for Workers’ Compensation (MPI-WC). The WCRI studied 25 states.

Picture Medical Fee Schedules Personnel Showing Hand Gesture

Tennessee was the best case example for using a fee schedule. Workers Comp medical treatment in Tennessee was very expensive before they enacted a fee schedule along with other reforms. Tennessee’s medical care cost for Workers Comp is now in line with most fee schedule states. It used to be one of the highest in the nation.

Wisconsin has become the bellwether for states that do not have a fee schedule. Their medical index cost was almost 200% more than the median. Wisconsin employers are feeling the effect in their Workers Comp E-mods and premiums.

The bottom line answer to the question is that Workers Comp fee schedules are beyond critical for controlling Workers Comp costs for employers. The employers in the aforementioned state should be pushing their lawmakers to pass some type of medical fee schedule very soon.

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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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