Turn on more accessible mode
Turn off more accessible mode
The Source You Trust
Search
800-622-4123
  • Contact Us
  • Products
    • Popular Products Riskworkstation™ NCCI Atlas Class Look-Up Data Manager Dashboard
    • Product Catalog
      Comprehensive library of NCCI's products.
  • About NCCI
    • Explore Careers
      People who join NCCI... can make an IMPACT.
    • Corporate Responsibility Facts and Information NCCI Cares Contact NCCI
    • Learn About NCCI About Us Our Leadership Media Center NCCI State Map
  • Learn@NCCI
    • NCCI Academy
      Curriculum-based learning exclusively for NCCI carriers and regulators.
    • Learning Center
      Topic-based learning for agents and available to all!
    • Other Learning Experiences NCCI Atlas Training Virtual Carrier Education Series Microlearning Videos
  • Log In
  • My Profile
    • My Contact Information My Email Notifications Recent ncci.com Updates My Products Company Administrators
    • Issues Tracking View/Pay My Invoice (OIS)
  • Data Reporting
  • Industry Information
  • Residual Markets
  • Underwriting
  • Agents/Brokers
  • Insights
Search
  • My Profile
    • My Contact Information
    • My Email Notifications
    • Recent ncci.com Updates
    • My Products
    • Company Administrators
    • Issues Tracking
    • View/Pay My Invoice (OIS)
  • Data Reporting
  • Industry Information
  • Residual Markets
  • Underwriting
  • Agents/Brokers
  • Insights
  • Contact Us
  • Products
    • Product Catalog
    • Popular Products
      • Riskworkstation™
      • NCCI Atlas
      • Class Look-Up
      • Data Manager Dashboard
  • About NCCI
    • Learn About NCCI
      • About Us
      • Our Leadership
      • Media Center
      • NCCI State Map
      • Corporate Responsibility
      • Facts and Information
      • NCCI Cares
      • Contact NCCI
    • Explore Careers
  • Learn@NCCI
    • Learning Center
    • NCCI Academy
    • Other Learning Experiences
      • NCCI Atlas Training
      • Virtual Carrier Education Series
      • Microlearning Videos
Insights
Medicare Fee Schedules and Workers Compensation in 2024
Medicare Fee Schedules and Workers Compensation in 2024
NCCI Page Content Two
​​​​InsightsResearch & Briefs
 
 
By Jon Sinclair and Katherine NorrisJune 20, 2024
 
​
Page Content

The Centers for Medicare and Medicaid Services (CMS) updates its reimbursement rules and rates for medical services each year. This report highlights the most relevant changes in the 2024 update and the potential impact on workers compensation (WC) medical costs.

Medical cost trends continue to be top of mind for industry stakeholders, and each year NCCI monitors changes in CMS reimbursement rules and rates that impact WC medical costs.

The impacts of these changes on WC medical costs vary by state. The medical service categories covered by medical fee schedules, the extent to which each fee schedule incorporates the CMS rules and rates, and the distribution of medical costs all influence how each state is impacted.

This report highlights the 2024 changes to CMS fee schedules for the following service categories:

  • Physician—Physician costs account for about 40% of countrywide WC medical expenditures. At AIS 2024, we shared that physician costs for states with fee schedules in place typically grow at a slower rate. See the slide from State of the Line:
 
  • Facility—Facility costs also account for about 40% of countrywide WC medical expenditures and facility base rates saw moderate increases in line with prior years.
  • Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)—The share of costs that DMEPOS represents varies by state, ranging between 4% and 13% of WC medical costs.

Key Findings

  • Effective January 1, 2024, CMS initially published the physician conversion factor of 32.7442, which was a 3.4% decrease from 2023.
    • Subsequently, Congress passed the Consolidated Appropriations Act, 2024, which included a temporary payment increase of 1.7%, effective March 9, 2024.
    • This change increased the conversion factor to 33.2875, a 1.8% decrease from 2023, from March 9 through the end of 2024.
  • CMS added a new code to the physician fee schedule in 2024.
    • This code, G2211, is an evaluation and management add-on code. We’ll monitor how commonly physicians utilize the code in WC.
  • Facility base rates saw moderate increases in the 2% to 3% range.
  • The 2.6% increase to the CMS DMEPOS update factor in 2024 is significantly lower than the increases seen in 2022 and 2023 of 5.1% and 8.7%, respectively.

Like 2023, the factors published by CMS continue to not be a source for significant upward pressure on workers compensation medical costs.

For more research findings, check out the complete report. Connect with the authors if you have questions or to gain additional insights.

​This article is provided solely as a reference tool to be used for informational purposes only. The information in this article shall not be construed or interpreted as providing legal or any other advice. Use of this article for any purpose other than as set forth herein is strictly prohibited.


TOP
NCCI Page Content Right Top

COMPLETE REPORT

Complete Report Medicare Fee Schedules and Workers Compensation in 2024
 

RELATED CONTENT

Related Content Image State of the Line Report
Related Content Image Medical Cost Trends—What's in the Mix?
Related Content Image Medicare Fee Schedules and Workers Compensation in 2023
Related Content Image Inflation and Workers Compensation Medical Costs - Overall Medical
Related Content Image Inflation and Workers Compensation Medical Costs - Facility Services
Related Content Image Inflation and Workers Compensation Medical Costs - Physician Services
Related Content Image Inflation and Workers Compensation Medical Costs - Prescription Drugs
 
​
NCCI
Home
About Us
Careers
Contact Us
Website SLA
QUICK LINKS
Events and Programs
Learning Center
NCCI Academy
Online Invoice Service (View/Pay My Invoice)
Recent ncci.com Updates
Product Catalog
Solutions
LEGAL
Privacy Policy
Terms of Use

CONNECT WITH US

We use cookies on this site to enhance your user experience. By continuing to use this site you are giving us your consent to place cookies on your device.

Continue Give me more information