ISMS Advocacy Results in Bump for Certain Reimbursement Rates!

January 27, 2023

Due to ISMS advocacy, the fee schedule for evaluation and management (E&M) codes increased by 15% for the Illinois Workers’ Compensation Commission (IWCC) Medical Fee Schedule. The increase took effect Sept. 1, 2022.

And there’s more. On January 1 of each year, the IWCC adjusts all fees by the percentage change in the Consumer Price Index for All Urban Consumers. Due to this automatic yearly adjustment, the fees for E&M codes were also raised by 8.3% for inflation.

When the 2023 Medical Fee Schedule was first published, IWCC made an error and used the pre-Sept. 1, 2022, reimbursement levels for the adjustments for the CPI increase on Jan. 1, 2023. ISMS member Dr. David Fletcher, who sits on the IWCC Medical Fee Advisory Board, informed the IWCC chair who then promptly took action to correct the mistake.

Thank you, Dr. Fletcher!

Overall, since last year, the reimbursement rates for office visits when treating Illinois’ injured workers has increased in total by 23.3%. While this improvement is something to celebrate, the Illinois MFS reimbursement for office visits still ranks among the lowest in the nation compared to other states according to Workers’ Compensation Research Institute (WCRI) data. There remains work to do!

ISMS continues to advocate for fair physician reimbursement rates for treating injured workers under Illinois’ worker’s compensation system.

If you have questions, please contact the ISMS Health Policy Research and Advocacy team by email.