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California workers comp reform moderates office visit costs despite rising fees

Posted On: Oct. 23, 2014 12:00 AM CST

California medical office visit fees have increased significantly after the state passed a workers comp reform bill in 2012, but changes in how medical providers are reimbursed for some billings may help moderate increases in total payments, according to the Workers Compensation Research Institute.

California S.B. 863 increased fee schedule prices paid for primary care office visits while decreasing prices paid for specialist services. Cambridge, Massachusetts-based WCRI said in a report released Thursday that payments for California medical office visits commonly related to workers comp are expected to increase 36%.

However, WCRI said S.B. 863 implemented changes in California workers comp medical reimbursement rules that would likely counterbalance increases in fees paid for primary care visits.

The reform bill eliminated separate billings and payments for services related to reporting, record review and consultations, which accounted for a total of 25% of services provided in 2012, according to WCRI.

By cutting such billings, WCRI projects that California workers comp office visit payments will increase 8% overall.