TDI-DWC 2015 Medical Fees Established
Written by Editor   
Wednesday, December 10, 2014 02:04 PM

The Texas Department of Insurance, Division of Workers’ Compensation reports in Commissioner’s Bulletin No. B-0023-14 that “Under Labor Code  Article 413.001(a), fee guidelines adopted by the Division of Workers’ Compensation for non-network services and approved out-of-network services are based on the most current reimbursement methodologies, models, and values or weights used by the federal Centers for Medicare and Medicaid Services."

“DWC established a conversion factor and an annual update … the annual update is based on the Medicare Economic Index, which is a weighted average of price changes for goods and services used to deliver physician services.  The Medicare Economic Index for 2015 reflects an increase of 0.8 percent."

“For services provided in calendar year 2015, the new Medical Fee Guideline factors are $56.20 and $70.54.  The conversion factor of $56.20 applies to service categories of evaluation and management, general medicine, physical medicine and rehabilitation, radiology, pathology, anesthesia, and surgery when performed in an office setting.  The conversion factor of $70.54 applies to surgery when performed in a facility setting."