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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-676

New Reimbursement Rates for Inpatient Hospital Care

Date: April 16, 2014

Pursuant to New York Public Health Law § 2807-c(b-1), the workers' compensation fee schedule for inpatient hospital care tracks New York Medicaid rates, with limited statutory modifications. These rates also apply to treatment provided under the Comprehensive Motor Vehicle Reparations Act, Volunteer Firefighters Benefit Law, and Volunteer Ambulance Workers' Law. The New York State Department of Health (DOH) is required by statute to promulgate the workers' compensation inpatient rates. The DOH recently provided the Workers’ Compensation Board (Board) with reimbursement rates for inpatient hospital care with discharge dates for 2014:

  • Medically managed detoxification (MMD) and medically supervised inpatient withdrawal (MSIW) reimbursement rates with discharge dates of January 1, 2014 through December 31, 2014. These rates reflect the detox rate reform provisions of Section 2807-c(4)(1) enacted under Chapter 58 of the Laws of 2008, and as subsequently revised under the Laws of 2009. The new rates are now posted on the Board’s website located under Health Care Information, Medical Care Fee Schedules, Inpatient and Outpatient Fee Schedules, 2014.
  • Inpatient hospital care reimbursement rates with discharge dates of January 1, 2014 through March 31, 2014. These rates are determined using the Medicaid inpatient methodology, All Patients Refined – Diagnostic Related Groups (APR-DRG). The new rates are now posted on the Board's website located under Health Care Information, Medical Care Fee Schedules, Inpatient and Outpatient Fee Schedules, 2014.
  • Inpatient hospital care exempt reimbursement rates with discharge dates of January 1, 2014 through December 31, 2014. These rates are determined using the Medicaid inpatient methodology, All Patients Refined – Diagnostic Related Groups (APR-DRG). The new rates are now posted on the Board’s website located under Health Care Information, Medical Care Fee Schedules, Inpatient and Outpatient Fee Schedules, 2014.

 

Robert E. Beloten
Chair