SCC Seeking Comments On Medical Services Provider Manual

Columbia, SC (CompNewsNetwork) - The South Carolina Workers' Compensation Commission is in the process of reviewing and revising the Medical Services Provider Manual (fee schedule). The fee schedule sets the maximum allowable fees physicians and other medical providers may be paid for authorized services provided to a workers' compensation patient. It does not include fees for hospital inpatient and outpatient services, services which are included in a separate fee schedule.

The next edition of the Medical Services Provider Manual will be a complete revision and include updates to payment policies, billing policies, evaluation and management services, anesthesia, surgery, radiology, pathology and lab services, medicine and injections, physical medicine, special reports and services, and supplies and durable medical equipment. All procedural codes and prices will be updated.

Since 1995 the Medical Services Provide Manual has been based on the Center for Medicare & Medicaid Services resource based relative value scale, RBRVS. RBRVS establishes a relative value for most medical services and is a well recognized and established method for determining price based on the work involved, the expense associated with providing that service, and malpractice insurance costs. RBRVS attempts to ensure that fees are based on the resources used to provide each service and utilizes one of the most systematic methods for setting prices. The relative value of each procedure is multiplied by a conversion factor to arrive at the maximum allowable payment. The current conversion factor is $52.00. Medicare's conversion factor for 2009 is $36.0666. All comments and recommendations are welcomed and can be submitted to the Medical Services Division, South Carolina Workers' Compensation Commission, Post Office Box 1715, Columbia, South Carolina 29202-1715. To allow time for full consideration, comments must be submitted by June 30, 2009. A public hearing also will be held to receive comments. The public hearing will be held Friday, June 19, 2009 at 10:00 am at the offices of the Commission, 1333 Main Street, Columbia, South Carolina.

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