Public comments delay implementation

A public hearing was held on May 16, 2008 concerning the proposed amendments and changes to the workers’ compensation medical fee schedule for facilities. Public comments voicing concerns about implementation timelines and methodology have led the department of labor & industry (DOLI) to delay implementation pending another hearing. Please see the Department of Labor & Industry’s website for further information at http://erd.dli.mt.gov/wcregs/medreg.asp.

Montana non-facility fee schedule (MNFS)

There are two different levels (facility and non-facility) of practice expense RVUs for each procedure code depending on the site-of-service:

• Non-facility column: the allowed fee paid for each service when that service is provided in non-facility settings, such as the physician’s office, patient’s home or other non-facility setting. The higher non-facility practice expense RVUs are used to calculate payments for services performed in a physician’s office and for services furnished to a patient in the patient’s home, or facility or institution other than a Hospital skilled nursing facility (SNF)or ambulatory surgical center (ASC). The physician typically bears the cost of resources (labor, medical supplies and equipment).
• Facility Column: the medical provider s allowed fee for each service when that service or procedure is provided in a hospital, ambulatory surgery center (ASC), skilled nursing facility(SNF)or other licensed medical facility setting

The lower facility practice expense RVUs are used to calculate payments for physicians’ services provided in a hospital, SNF or ASC facilities. The cost (resources) for providing the services is typically borne by the hospital  SNF or ASC.