Impact of the RBRVS Fee Schedule on California Workers Comp Physician & Non-Physician Practitioner Service Payments (Report to the Industry, published 08/16)


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A detailed analysis of changes in the utilization and reimbursement of California workers’ compensation physician and non-physician medical services during the first two years of the transition to the Resource Based Relative Value Scale (RBRVS) fee schedule, which began in January 2014. The report provides background information on the transition to the new schedule, then uses data on 11.4 million medical services rendered in 2013, 2014, and 2015 to measure changes in service volume and total amounts paid by medical service category, the percent change in unique claims by service category, the changes in the weighted average payments for each of those 8 categories and overall, the resulting redistributions of medical services and payments governed by the RBRVS fee schedule, as well as the change in the average paid per date of service per service category. In addition, the report identifies the top 10 services in the 8 fee schedule categories for service years 2013, 2014, and 2015, based on the total volume and payments, then notes the changes in the payment and service distributions, the rankings of the top 10 services and the amounts paid per code.