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Fee Schedules Effect on Workers Comp Costs – New Study From NCCI


NCCI Study on Effect of Fee Schedules

NCCI is one of my favorite companies.  They recently produced a great study on fee schedules.

Old picture of woman fee schedules using old telephone
Wikimedia Commons – Internet Archive Book Images

They have always been very nice to me and oh, so helpful at any of their meetings and conferences that I have attended over the years; and their phone assistance is great. Similar to WCIRB (California) and WCRI (independent research company), the  research produced by NCCI is always insightful and the best when it comes to Workers Comp medical costs.

The newest study by NCCI can be found here.(PDF file) I may be viewing the term “physician impact fees” incorrectly. However, fee schedules have and always will reduce costs when compared to paying a Usual and Customary rate.

The key findings from the NCCI study were:

  • Large discounts off the WC physician fee schedule maximum allowable reimbursements do not ensure low prices
  • WC MARs not only limit payments, they may also become common WC prices—the median WC price is always at or very near the fee schedule
  • Surgery has higher fee schedules than Evaluation and Management relative to Group Health payments
  • Similar WC discounts do not necessarily imply similar prices relative to Group Health:
  • In some states, even after large discounts off the state physician fee schedule, the prices for some services may remain high relative to Group Health payments
  • In other states, a smaller discount may produce prices more in line with Group Health payments

Instead of me opining on the study, please feel free to comment on the study or email me at [email protected] .   I will add more comments on the study this week or the next.

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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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