2025 Fee Schedules
Effective July 1, 2025
This site contains the policies, payment methods, billing codes, and maximum fees used to pay health care and vocational providers who treat injured workers.
Make sure to check the Updates & Corrections tab for any changes to the Fee schedules. Read about the highlights of changes in the last year. These changes are also included in the payment policies.
2025 Quick Reference Fee Schedule (English) Español (Spanish)
Professional and Facility Services Fee Schedules (July 2025)
Note: These fee schedules have been enhanced with search features for your convenience. Enable Macros in Excel for the files below to open without errors. These files are best viewed in the desktop application and not the web browser.
- Professional Services Fee Schedule — Excel spreadsheet of the complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates. This fee schedule has been enhanced with a search feature for your convenience.
Note: For your reference here are the code ranges you will find in the professional fee schedule.
-
- Evaluation and Management — CPT® 98000 - 98016 and 99202 - 99499
- Surgery — CPT® 10004 - 69990
- Radiology — CPT® 70010 - 79999
- Pathology and Laboratory — CPT® 80047 - 89398 and 0001U - 0216U
- Medicine — CPT® 90281 - 99607
- CPT® Category II and III — CPT® 0001F - 0566T
- HCPCS — A0021 - V5364
- Medical and Surgical Supplies Codes — HCPCS A4206 - A9999 (For DME Providers)
- Facility Only Codes — C1605 - Q5133
- Local Codes —Local Codes Listed by Specialty
- Anesthesia — CPT® 00100 - 01999
- ASC Fee Schedules — All approved codes
- APR-DRG Assignment — Version 38
- Hospital Rates
- Residential Facility Rates
Fee Schedules - Comma delimited version with Field Key
- Complete fee schedule excluding the ASC Fees, AP-DRGs, Hospital Rates and Residential Facility Rates, Field Key
- Anesthesia
- Ambulatory Surgery Center Field Key
- APR-DRG Field Key
- Hospital Field Key
2025 Billing & Payment Policies
Effective July 1, 2025
These billing and payment policies determine under what conditions we will pay health care and vocational providers who treat injured workers and crime victims.
Note: Make sure to check the Updates & Corrections tab for any changes to the Payment policies.
Payment Policies Complete (2025)
| Chapter Title | Topics |
|---|---|
| Introduction | |
| General provider information, billing, chart notes, roles and responsibilities | |
| General information for Attending Providers, details for specific providers (such as chiropractors and naturopaths), consultations, 1044M | |
| Audiology, hearing aids | |
| Nurse case management, phone calls, online communications, team conferences, health services coordination | |
| Dental services | |
| Medical equipment, supplies | |
| Imaging, EKG, biofeedback | |
| Evaluation and management services, separately billable services | |
| Modifications to homes, vehicles | |
| Impairment ratings and IMEs | |
| Injections, infusions, acupuncture, dry needling | |
| Immunizations, pathology, laboratory services | |
| Spoken language interpretation services | |
| Lodging, taxi, ambulance, travel reimbursement | |
| Medical testimony | |
| Mental health evaluation, treatment, behavioral health interventions, PGAP | |
| Obesity, sign language, document translation services, best practice provider incentives, worker reimbursement | |
| Opioids, medications and drugs | |
| Physical therapy, occupational therapy, massage, chiropractic care | |
| Commonly billable reports and forms | |
| RBRVS | |
| Surgical care | |
| Telehealth, remote services, and mobile clinics | |
| Vocational services | |
| Hospitals, ambulatory surgical centers | |
| Brain injury programs (BIRP), structured intensive multidisciplinary program (SIMP), residential treatment facilities | |
| Skilled nursing, adult family homes, assisted living, home health care | |
| Terms used in MARFS | |
| Modifiers used in MARFS | |
| POS codes used in the workers compensation system | |
2025 Updates and Corrections
Updates
| Posting date | Policy Area | Description |
| Posting date | Description | Updated Version |
Corrections
| Posting date | Policy Area | Description |
| Posting date | Description | Updated Version |