Boca Raton, FL – The National Council on Compensation Insurance (NCCI) recently released a new Insights brief on 2023 Medicare Fee Schedules and Workers Compensation.
The Centers for Medicare and Medicaid Services (CMS) updates its reimbursement rules and rates for medical services each year. The report highlights the most relevant changes in the 2023 update and the potential impact on workers compensation (WC) medical costs.
The National Council on Compensation Insurance (NCCI) monitors changes in CMS reimbursement rules and rates that impact WC medical costs. The impacts of these changes on WC medical costs vary by state. The medical service categories covered by medical fee schedules, the extent to which each fee schedule incorporates the CMS rules and rates, and the distribution of medical costs all influence how each state is impacted. NCCI’s report, “Medicare Fee Schedules and Workers Compensation in 2022“, highlighted noteworthy aspects of the 2022 update.
The report focuses on the 2023 changes to CMS fee schedule rates, the data CMS relied on to develop those rates, and other potentially impactful changes to the fee schedules for the following service categories:
- Facility (hospital outpatient, ambulatory surgical centers, hospital inpatient)
- Facility costs account for about 40% of countrywide WC medical expenditures.
- Physician
- Physician costs account for about 40% of countrywide WC medical expenditures.
- Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
- Costs that DMEPOS services represent vary by state, ranging between about 4% and 13% of WC medical costs.
CMS implemented higher increases to payment rates for facility services and DMEPOS in 2023 relative to recent years. Conversely, CMS decreased 2023 payment rates for physician services.
The report is authored by Jon Sinclair, FCAS, MAAA, Director & Actuary and Katherine Norris, Actuarial Analyst.
Read the free brief: NCCI: Medicare Fee Schedules and Workers’ Compensation in 2023
Source: NCCI