Morgan’s Tip of the Week- Pending FL fee schedule changes


The Florida Legislature passed a bill increasing the fee schedule physicians can charge for treating a WC patient.  The bill is awaiting the Governor’s signature before becoming law, tentatively effective 1/1/2025.

A link to a copy of the bill is below, along with a link to an article on the changes.   The Florida fee schedule reimbursement allowance has been tied to 110% of the Medicare rates,  with surgical procedures being 140% of the Medicare rates.

The bill increases the maximum reimbursement allowances (MRA) for physicians licensed under ch. 458, F.S., or ch. 459, F.S., from 110 percent to 175 percent of the reimbursement amount allowed by Medicare, and increases the MRA for surgical procedures from 140 percent to 210 percent of reimbursement amount allowed by Medicare.

Over the years we have certainly seen a reduction in the number of providers willing to treat WC patients, partly due to the low fee schedule.  While this change will increase medical costs, hopefully it will bring more conservative doctor choices into the system, allowing us to shut down claims quicker to balance the increase in costs.  In many areas of the state, we have very limited choices of providers.

From a strategic standpoint, Medicare Set-Aside pricing is tied to the Florida fee schedule.   Assuming the bill is signed and goes into effect in January 2025, an MSA run in 2024 would be significantly cheaper than one run in 2025.   If you have any claims that may be ripe for an MSA, perhaps running one now and sending to CMS for approval now may be the most cost-effective way of handling the exposure.

Here are the links, and if you are attending the WCCP Board Certification Forum in April in Orlando, let me know so I can share our firm’s events.

Senate votes unanimously to update Florida’s workers’ comp reimbursement rates | The Capitolist


Morgan Indek | Managing Partner