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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
20 Park Street   Albany, New York 12207
Governor Eliot Spitzer


Subject No. 046-210

Dental Fee Schedule

Date: October 9, 2007

On March 13, 2007, Governor Spitzer signed into law comprehensive workers' compensation reform legislation. As part of this legislation, Workers' Compensation Law (WCL) §13-a was amended to direct that the Chair of the Workers' Compensation Board prepare and establish a schedule of charges and fees for dental services.

Specifically, WCL §13-a now provides that:

The chair shall prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for such medical treatment and care, and including all medical, dental, surgical, optometric or other attendance or treatment, nurse and hospital service, medicine, optometric services, crutches, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices and apparatus in accordance with and to be subject to change pursuant to rules promulgated by the chair. [Emphasis added]

This statutory change applies to dental services occurring on or after July 11, 2007.

In an effort to determine the proper level of reimbursement for dental services associated with workers' compensation claims, the Board contacted the New York State Dental Association (NYSDA). The NYSDA provided the Board with data they had previously gathered to support a revision to the No-Fault dental fee schedule.

The fees are based on American Dental Association (ADA) Current Dental Terminology (CDT). The proposed dental fee schedule has values associated with approximately 60% of the CDT codes. We are first, seeking comments on the adequacy of the fees assigned and second, asking you to identify those procedure codes that would be provided in a workers' compensation claim that presently do not have a value associated with them. In addition, we need you to identify the level of reimbursement for these codes.

To obtain a copy of the proposed dental fee schedule, please contact:

Cheryl M. Wood, General Counsel
Office of General Counsel
New York State Workers' Compensation Board
20 Park Street, Room 401
Albany, New York 12207
or
officeofgeneralcounsel@wcb.ny.gov

Written comments may also be submitted to the Office of General Counsel as indicated above. Comments should be submitted as soon as possible, but no later than November 1, 2007.

 

Donna Ferrara
Chair