Great News! Non-Surgical E/M Services for Workers’ Comp Get 15% Reimbursement Bump

October 6, 2022

ISMS’ work behind the scenes advocating on your behalf recently scored a win for members pertaining to reimbursements!

The Illinois Workers’ Compensation Commission (IWCC) recently issued an order that increases the reimbursement rates for non-surgical Evaluation and Management (E/M) services by 15%. 

As of Sept. 1, 2022, these are the CPT codes affected by the increase:

99203, 99204, 99205, 99213, 99214, 99215

The rate change applies to all Fee Schedule regions.

Concern over adequate access to care was the primary reason for the reimbursement hike. The Illinois Fee Schedule rate was previously below Medicare reimbursement rates and the IWCC has the statutory authority to increase medical fees if they determine that low reimbursements impact patient access to care.

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