Date: March 9, 2009
The workers' compensation reform legislation signed on March 13, 2007 amended the Workers' Compensation Law to require the Chair of the Workers' Compensation Board to adopt a dental fee schedule. A Notice of Proposed Rule Making was published in the December 24, 2008 edition of the State Register. The proposed regulation incorporated by reference the Official New York Workers' Compensation Dental Fee Schedule, First Edition, March 1, 2009, and set time frames and a process for the payment of dental bills and requests for reimbursement. Public comments were accepted through February 9, 2009. The Chair adopted a new dental fee schedule by regulation effective March 1, 2009, which is codified as The Part 444 of Title 12 of the New York Codes, Rules and Regulations. The adoption of the new dental fee schedule was published in the February 25, 2009 edition of the State Register.
The new dental fee schedule is applicable to dental treatment and procedures performed on or after March 1, 2009, for the necessary care and treatment of an injured employee, regardless of the date of accident or date of disablement. Dental treatment and procedures performed prior to March 1, 2009, shall be reimbursed at the usual and customary rate in the location where the claimant resides.
The dental fee schedule for all dental services shall be the Official New York Workers' Compensation Dental Fee Schedule, First Edition, March 1, 2009, prepared by the Chair and published by the Board. The fees listed in the fee schedule are the maximum reimbursable amounts except as described in Part 444.2(1) of Title 12 of the New York Codes, Rules and Regulations.
Copies of the fee schedule may be obtained from the Board by writing to the Bureau of Health Management, New York State Workers' Compensation Board, 100 Broadway-Menands, Albany, N.Y. 12241, by telephone at 1-800-781-2362 or by e-mail at firstname.lastname@example.org. Copies can also be viewed at each district office of the Workers' Compensation Board and other State offices described in part 442.2(2) of the regulations.
The dental fee schedule can be viewed electronically on the Board's web site only by those parties involved in billing, or paying, for a dental procedure in a workers' compensation case. Self-insured employers, third-party administrators, insurance carriers and dentists may view the Official New York Workers' Compensation Dental Fee Schedule in a secure area of the Board's website from the Medical Fee Schedules link on the Health Care Information web page. First time users will need to register to obtain a user id and password to access the fee schedule.
Questions regarding the dental fee schedule or the regulations should be referred to the Bureau of Health Management at 1-800-781-2362.
Zachary S. Weiss