Workers' Compensation Fee Schedule by Region

Keywords: Workers_Compensation  


Do you know what you are supposed to be paid for non-network workers’ compensation services according to the updated 2010 Workers’ Compensation Medical Fee Guideline?

The Texas Department of Insurance (TDI) Division of Workers' Compensation announced in early November the annual changes to conversion factors for workers' compensation medical fee guidelines for professional services, charges, and payments using the Medicare Economic Index (MEI).

"The MEI, reported as a 1.2-percent increase for 2010, is a weighted average of price changes for goods and services used to deliver physician services," according to a TDI bulletin.

For services provided in calendar year 2010, the new medical fee guideline conversion factors are $54.32 and $68.19. The conversion factor of $54.32 applies to evaluation and management services, general medicine, physical medicine and rehabilitation, radiology, pathology, anesthesia, and surgery when performed in an office.

The conversion factor of $68.19 applies to surgery performed in a health care facility.


These fee schedules do not incorporate all factors related to the Texas Department of Insurance, Division of Workers Compensation payment rules, such as policies regarding payment of consultation codes, the applicability of OPPS payment limits, or definitions of various payment terms. The source for correct information on these and other Texas worker’s compensation payment issues is the Texas Department of Insurance (Note – TDI does not give coding advice).

Note: Please use Excel to open all sheets.

The 2010 Workers' Compensation fee schedule by geographic region.

The 2009 Workers' Compensation fee schedule by geographic region.

TMA has provided the Workers' Compensation fee schedule by geographic region. The fees for non-network and out of network payments were effective Jan. 1, 2009.

The 2008 Workers' Compensation fee schedule by geographic region.

TMA has provided the Workers' Compensation fee schedule by geographic region. The fees for non-network and out of network payments were effective March 1, 2008.

Last Published: 5/7/2010

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