May 2002

Research Institute Compares States' Fee Schedules

Cambridge, Mass. – The Workers Compensation Research Institute (WCRI) has released a study that compares established fee schedules for regulating reimbursements made to medical doctors, chiropractors, and physical therapists in various states.

One portion of the study compared the fee schedules in "larger"-sized states, including Florida, California, Connecticut, Massachusetts, Minnesota, New York, Pennsylvania, and Texas.

Massachusetts has the lowest fee schedule, and Florida 's was the second-lowest. Massachusetts was 5% lower than Florida, due primarily to the relatively low surgery reimbursement rates in that state. Most of the states had fee schedules 24% to 60% higher than Massachusetts.

The study also compared several southern states, including Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina. Florida had the lowest fee schedule among the southern states studied. South Carolina had the second-lowest fee schedule level, which was 37% higher than in Florida. Mississippi had the highest value - 79% above the Florida level.

However, the actual average price paid to Florida hospitals are among the highest of the eight large states studied by WCRI. In fact, the average fees paid to hospitals are as much as five times higher than fee schedule amounts for non-hospital providers for similar services, according to the study.

"The relatively high payments to hospitals compared to the relatively low payments to non-hospital providers suggests that public officials may want to revisit the reimbursement regulations for both hospital and non-hospital providers," said Stacey Eccleston, senior analyst at WCRI and the study's lead author.

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