TX Upholds WC Medical Fee Schedule

A recently released Texas trial court ruling will help control workers compensation medical costs by setting reasonable medical fees within the state‘s workers compensation system, according to the Alliance of American Insurers. The ruling, by Travis County Judge John Dietz, upheld a revised medical fee guideline promulgated by the Texas Workers Compensation Commission (TWCC) last year. "The ruling will reduce medical claims costs by about 6 percent by reducing highly-overpaid surgical services and increasing fees for underpaid General Practitioners," said Joe Woods, assistant vice president of the Alliance‘s Southwest Region. Last year, TWCC adopted a new medical fee guideline based on legislation of the 2001 Legislative Session. The guidelines adopted Medicare billing, coding and payment policies and set the reimbursement rate for physician services at 125 percent of Medicare.