As we previously reported in our No-Fault Insurance Law Wrap-Up (NYLJ, April 10, 2019), the new Worker’s Compensation Fee Schedule, as applicable to no-fault medical claims, takes effect for services rendered on or after Oct.1. The effective date for workers’ compensation claims was April 1, 2019, but it was delayed for 18 months for no-fault claims to permit automobile insurers sufficient time to determine and mitigate the effects of any increases in claims payments and any increases in premiums resulting therefrom. See 35th amendment to Insurance Regulation 83 (11 NYCRR 68.1). Certain ground rules contained in the revised fee schedule (requiring that chiropractors, podiatrists and psychologists bill only under their own respective fee schedules), however, took effect for no-fault claims on April 1, 2019.

The changes are many, and can be summarized as follows: 1) Increase in regional conversion factors, which translates to an increase in the chargeable amount for most services, 2) Increase in the daily maximum RVU (relative value units) applicable to most physical medicine modalities from 8 to 12; 3) Changes to numerous CPT® (Current Procedural Terminology) codes, resulting in the addition of new codes, the deletion of certain codes, changes in relative value of certain codes and changes in the description of services of certain codes and 4) the addition or change to several ground rules.

Vacating Arbitration Awards

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