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Wednesday, August 17, 2011

IWCC Posts New Fee Schedules

The IWCC recently updated their fee schedule tables with the new Illinois workers’ compensation state fee schedule rates effective September 1, 2011.  This is the HB 1698–mandated 30% reduction of all institutional & professional fee schedules in the existing 29 geozip regions.  HB 1698’s additional fee schedule modifications also become effective on September 1.

This update is a straightforward 30% across-the-board reduction utilizing the existing 29 regions; however, the January 1, 2012 fee schedule region modification is a major change that will significantly affect provider reimbursement rates.  That modification is a complete restructuring of the regions and fee schedule calculations that will determine the fee schedule reprice amounts. 

As of the last IWCC Workers' Compensation Medical Fee Advisory Board meeting, the Board had not made a determination on how the fee schedules will be recalculated for the new regions.  Hopefully, the next Board meeting, on August 23, will provide more details on how the 29 existing regions’ fee schedule rates are going to be collapsed into 4 “non-hospital” regions and 14 “hospital” regions.  Until those decisions are finalized, it is impossible to determine the impact of these modifications.  We will report back any updates from the August 23rd Board meeting next week.

New Illinois Workers’ Comp Fee Schedule Regions

4 Regions for “Non-Hospital Fee Schedule Amounts”
1.    Cook County
2.    DuPage, Kane, Lake, & Will Counties
3.    Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. Clair, & Washington Counties (southwestern Illinois counties across the Mississippi River from St. Louis)
4.    All other counties in the state

14 Regions for “Hospital Fee Schedule Amounts”
1.     Cook, DuPage, Will, Kane, McHenry, DeKalb, Kendall, & Grundy Counties
2.     Kankakee County
3.     Madison, St. Clair, Macoupin, Clinton, Monroe, Jersey, Bond, & Calhoun Counties
4.     Winnebago & Boone Counties
5.     Peoria, Tazewell, Woodford, Marshall, & Stark Counties
6.     Champaign, Piatt, & Ford Counties
7.     Rock Island, Henry, & Mercer Counties
8.     Sangamon & Menard Counties
9.     McLean County
10. Lake County
11. Macon County
12. Vermilion County
13. Alexander County
14. All other counties in the state

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