Changes in Workers’ Compensation Physician Reporting Under California’s RBRVS Fee Schedule: Initial Results (01/15) [PDF]


Changes to the Official Medical Fee Schedule (OMFS) mandated by SB 863 were expected to impact physician reporting in work injury cases. This analysis provides an initial look at physician reporting in the wake of the 2012 reforms and the changes in physician report billing codes. The research compares the volume, distribution and reimbursement of physician reports from the 1stquarter of 2014 to 1st quarter data from each of the three prior years, linking the reduction in the average amount paid for all reports to the changes in the underlying Evaluation and Management services that were introduced with the adoption of the RBRVS fee schedule rather than a decrease in the fee schedule amounts assigned to report code. The study also documents a reduction in the average number of reports per claim, which it suggests is likely due to the elimination of separate reporting associated with consultations and prolonged services.

(Research Update, 01/15)

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