New York No-Fault Fee Schedule: What You Need to Know

In October, New York will implement major changes to its fee schedule for auto casualty no-fault claims, which includes increased rates and significant changes to specific ground rules stating that providers may not bill outside of their section of the fee schedule.

Find out what you need to know now to comply and what impact it may have for insurers and medical providers operating in the state of New York.

More than 25 changes will go into effect under the new fee schedule for health services performed on or after October 1, 2020, modifying the previous fee schedule, which was last updated in 2012.

More information about the updates can be found in the 34th amendment and 35th amendment to 11 NYCRR 68 (Insurance Regulation 83). To summarize, some of the updates include: 1. Physical Modalities - The maximum recommended amount has been increased per patient per day, regardless of the number of providers. 2. Range of Motion and Physical Performance Testing - A relative value unit of zero for any provider.

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