Workers Comp Term Of the Day - Fee Schedule

States without Workers Compensation fee schedules are becoming more rare every year. At last count, there are approximately 42 states with fee schedules. A fee schedule basically allows a maximum charge for a medical provider (physician, hospital, physical therapist, etc.) per CPT code.

The medical provider can charge much more than the fee schedule. The charge will be cut to the fee schedule unless there are extenuating circumstances. In some states, a BR or by report is added to the CPT code to let the insurance carrier and the Industrial Commission know that their bill needs to be reviewed individually and not just cut to fee schedule. I often see BR CPT codes coming from university-based medical providers.