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Workers’ Compensation Board

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

Subject No. 046-748

New Reimbursement Rates for Acute Inpatient Hospital Care

Date: January 29, 2015

Pursuant to New York Public Health Law § 2807-c(6-1), the workers’ compensation fee schedule for inpatient hospital care tracks New York Medicaid rates, with limited statutory modifications.

The New York State Department of Health (DOH) is required by statute to promulgate the workers’ compensation inpatient rates. These rates also apply to treatment provided under the Comprehensive Motor Vehicle Reparations Act, Volunteer Firefighters’ Benefit Law, and Volunteer Ambulance Workers’ Benefit Law.

The DOH recently provided the Workers’ Compensation Board (Board) with reimbursement rates for acute inpatient hospital care with discharge dates of July 1, 2014 through December 31, 2014. These rates are determined using the Medicaid inpatient methodology, All Patients Refined – Diagnostic Related Groups (APR-DRG).

Please note: These rates are retroactive for discharges on and after July 1, 2014. The 2014 APR-DRG SIWs and 2014 v31 grouper are to be used in conjunction with these rates.

The new rates are located under Health Care Information, Medical Care Fee Schedules, Inpatient & Outpatient Fee Schedules, 2014. Questions related to this announcement can be directed to the Medical Directors’ Office by email at:


Robert E. Beloten