The Official New York Workers' Compensation Medical Fee Schedule may be purchased from OptumInsight 360 by writing to PO Box 88050, Chicago, IL 60680-9920, by calling (800) 464-3649 option 1 or online at https://www.optum360coding.com/, keyword New York, or https://www.optum360coding.com/Product/40508/. The Fee Schedule may also be examined at the Office of the Department of State, 162 Washington Ave., Albany, NY 12231, the Legislative Library, the libraries of the New York State Supreme Court, and the Workers' Compensation Board District Offices.
If you have any questions regarding the information contained in the links below, please contact the Department of Health, Bureau of Primary and Acute Care Reimbursement at 518-486-7164 or email HospFFSunit@health.ny.gov.
- Department of Health Letters for updated hospital reimbursement rates - Effective 1/1/2020 - 12/31/2020
- Inpatient Exempt Unit Rates Effective 01/01/2020 - 12/31/2020
- Inpatient Exempt Unit Rates Effective 01/01/2020 - 12/31/2020 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2020 - 12/31/2020
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2020 - 12/31/2020 (MS Excel)
- Calculation Worksheet Effective 01/01/20 - 12/31/20 (MS Excel)
- Department of Health Letters for updated hospital reimbursement rates - Effective 1/1/2019 - 12/31/2019
- Inpatient Exempt Unit Rates Effective 01/01/2019 - 12/31/2019
- Inpatient Exempt Unit Rates Effective 01/01/2019 - 12/31/2019 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2019 - 12/31/2019
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2019 - 12/31/2019 (MS Excel)
- Calculation Worksheet Effective 01/01/19 - 12/31/19
- Calculation Worksheet Effective 01/01/19 - 12/31/19 (MS Excel)
- Department of Health Letters for updated hospital reimbursement rates - Effective 1/1/2018 - 12/31/2018
- Inpatient Case Payment Rates Effective 01/01/2018 - 12/31/2018
- Inpatient Exempt Unit Rates Effective 01/01/2018 - 12/31/2018
- Inpatient Case Payment Rates including (Exempt Unit Rates) Effective 01/01/2018 - 12/31/2018 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2018 - 12/31/2018
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2018 - 12/31/2018 (MS Excel)
- Department of Health Letters for updated hospital reimbursement rates - Effective 07/01/18 - 12/31/18
- Inpatient Case Payment Rates Effective 07/01/18 - 12/31/18
- Inpatient Case Payment Rates Effective 07/01/18 - 12/31/18 (MS Excel)
- APR-DRG Service Intensity Weights, Average Length of Stay and High Cost Outlier Thresholds July 1, 2018 Effective 07/01/18 - 12/31/18
- APR-DRG Service Intensity Weights, Average Length of Stay and High Cost Outlier Thresholds July 1, 2018 Effective 07/01/18 - 12/31/18 (MS Excel)
- Calculation Worksheet Effective 07/01/18 - 12/31/18
- Calculation Worksheet Effective 07/01/18 - 12/31/18 (MS Excel)
- Department of Health Letter for updated inpatient psychiatric exempt unit services - Effective 7/1/2018 - 12/31/2018
- Psychiatric Reform Calculation Worksheet Effective 07/01/18 - 12/31/18
- Psychiatric Reform Calculation Worksheet Effective 07/01/18 - 12/31/18 (MS Excel)
- Psychiatric Inpatient Exempt Case Payment Rates Effective 07/01/18 - 12/31/18
- Psychiatric Inpatient Exempt Case Payment Rates Effective 07/01/18 - 12/31/18 (MS Excel)
- Department of Health Letters for updated hospital reimbursement rates - Effective 4/1/2017 - 12/31/2017
- Inpatient Case Payment Rates (update summary) Effective 04/01/2017 - 12/31/2017
- Inpatient Case Payment Rates Effective 04/01/2017 - 12/31/2017
- Inpatient Case Payment Rates including (Exempt Unit Rates) Effective 04/01/2017 - 12/31/2017 (MS Excel)
- Inpatient Exempt Unit Rates Effective 04/01/2017 - 12/31/2017
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 04/01/2017 - 12/31/2017
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 04/01/2017 - 12/31/2017 (MS Excel)
- Department of Health Letters for updated hospital reimbursement rates - Effective 1/1/2017 - 12/31/2017
- Calculation Worksheet Effective 01/01/2017 - 12/31/2017 (MS Excel)
- 2014 SIWs and ALOS cost threshold
- 2014 SIWs and ALOS cost threshold (MS Excel)
- Inpatient Case Payment Rates Effective 01/01/2017 - 12/31/2017
- Inpatient Exempt Unit Rates Effective 01/01/2017 - 12/31/2017
- Inpatient Case Payment Rates including (Exempt Unit Rates) Effective 01/01/2017 - 12/31/2017 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2017 - 12/31/2017
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2017 - 12/31/2017 (MS Excel)
- Department of Health Letters for 2016 hospital reimbursement rates - Effective 01/01/2016 - 12/31/2016
- Calculation Worksheet Effective 01/01/2016 - 12/31/2016 (MS Excel)
- Inpatient Case Payment Rates Effective 01/01/2016 - 12/31/2016
- Inpatient Exempt Unit Rates Effective 01/01/2016 - 12/31/2016
- Inpatient Case Payment Rates (including Exempt Unit Rates) Effective 01/01/2016 - 12/31/2016 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2016 - 12/31/2016
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2016 - 12/31/2016 (MS Excel)
- Department of Health Letters for updated hospital reimbursement rates - Effective 04/01/2015 - 12/31/2015
- 2015 WCNF and Exempt Rates Update Summary
- Inpatient Case Payment Rates Effective 04/01/2015 - 12/31/2015
- Inpatient Exempt Unit Rates Effective 04/01/2015 - 12/31/2015
- Inpatient Case Payment Rates (including Exempt Unit Rates) Effective 04/01/2015 - 12/31/2015 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 04/01/2015 - 12/31/2015
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 04/01/2015 - 12/31/2015 (MS Excel)
- Calculation Worksheet Effective 04/01/2015 - 12/31/2015 (MS Excel)
- Department of Health Letter for revised Inpatient Psychiatric rates - EFFECTIVE 1/1/2015 - 12/31/2015
- 2015 Jan-Dec revised Hospital Inpatient Psychiatric Rates
- 2015 Jan-Dec revised Hospital Inpatient Psychiatric Rates (MS Excel)
- Department of Health Letter and Hospital Inpatient Fee Schedule Effective 01/01/2015 - 12/31/2015
- Inpatient Case Payment Rates Effective 01/01/2015 - 12/31/2015 (MS Excel)
- Inpatient Chemical Dependency Detox Per Diem Rates Effective 01/01/2015 - 12/31/2015 (MS Excel)
- Calculation Worksheet Effective 01/01/2015 - 12/31/2015 (MS Excel)
2015 New Facility Schedules
- Department of Health Letter for revised Inpatient Psychiatric rates - EFFECTIVE 7/1/2014 - 12/31/2014
- 2014 Jul-Dec revised Hospital Inpatient Psychiatric Rates
- 2014 Jul-Dec revised Hospital Inpatient Psychiatric Rates (MS Excel)
- Department of Health Letter - Inpatient Rates Effective July 1, 2014 - December 31, 2014
- Inpatient Rates Effective 07/01/2014 - 12/31/2014
- Inpatient Rates Effective 07/01/2014 - 12/31/2014 (MS Excel)
- APR-DRG Service Intensity Weights and Average Length of Stay July 1, 2014
- Department of Health Letter and Calculation Worksheet - Inpatient Rates Effective 01/01/2014 - 03/31/2014
- Department of Health Letter - Inpatient Rates Effective 4/1/2014 - 6/30/2014
- Detox Billing Instructions 2014
- 2014 Inpatient Chemical Dependency Detox Per Diem
- 2014 Inpatient Chemical Dependency Detox Per Diem (MS Excel)
- Inpatient Rates Effective 01/01/2014 - 03/31/2014
- Inpatient Rates Effective 04/01/2014 - 06/30/2014
- Inpatient Rates Effective 01/01/2014 - 03/31/2014 (MS Excel)
- Inpatient Rates Effective 04/01/2014 - 06/30/2014 (MS Excel)
- Inpatient Exempt Unit Rates Effective 01/01/2014-12/31/2014
- Inpatient Exempt Unit Rates Effective 01/01/2014-12/31/2014 (MS Excel)
2014 New Facility Schedules
- Department of Health - 2013 Inpatient Rates Letter
- 2013 Inpatient Chemical Dependency Detox Per Diem
- 2013 Inpatient Chemical Dependency Detox Per Diem (MS Excel)
- 2013 Inpatient Rates
- 2013 Inpatient Rates (MS Excel)
2013 New Facility Schedules
- New York Eye Surgical Center
- Rochester Ambulatory Surgery Center
- Brooklyn Ambulatory Surgery Center
- Surgery Center at Orthopedic Associates
- Plastic Surgery Center of Westchester
- Western NY Medical Management
- Syracuse Surgery Center
2013 Revised/Updated Facility Schedules
- 2012 Jan-Dec Hospital Inpatient Fee Schedule
- 2012 Jan-Dec Final APR-DRG SIWs Thresholds
- 2012 Jan-Dec Hospital Inpatient Fee Schedule (MS Excel - Zip File)
- 2012 Jan-Dec Final APR-DRG SIWs Thresholds (MS Excel)
2012 Revised/Updated Facility Schedules
2012 New Facility Schedules
For Psychiatric Reform Rates for 1/1/11 to 12/31/11, please see 2012 fee schedule.
- Camillus Surgery Center
- 2011-Jan-Dec Hospital Inpatient Fee-Facility Update-Jan 10 2012
- 2011-Jan-Mar-Corrected Hospital Inpatient-Chemical Dependency Detox Rates-Changes Jan 10 2012
- 2011 Jan-Mar Corrected Hospital Inpatient-Chemical Dependency Detox Rates
- 2011 Jan-Mar Hospital Inpatient-Chemical Dependency Detox Rates
- 2011 Jan-Dec Hospital Inpatient Fee Schedule
- 2011 Jan-Dec Hospital Inpatient Fee Schedule (MS Excel - Zip File)
- 2011 Jan-Mar Hospital Inpatient Fee Schedule
- 2011 Jan-Mar Hospital Inpatient Fee Schedule (MS Excel - Zip File)
2011 New Facility Schedules
For Psychiatric Reform Rates from 10/20/10 to 12/31/10, please see 2012 fee schedule.
- 2010-Oct-Dec-Hospital Inpatient Fee-Facility Update- Jan 10 2012
- 2010 Apr-Dec Hospital Inpatient-Chemical Dependency Detox Rates
- 2010 Jan-Mar Hospital Inpatient-Chemical Dependency Detox Rates
- 2010 Oct-Dec Hospital Inpatient Fee Schedule
- 2010 Oct-Dec Hospital Inpatient Fee Schedule (MS Excel - Zip File)
- 2010 Apr-Sep Hospital Inpatient Fee Schedule
- 2010 Apr-Sep Hospital Inpatient Fee Schedule (MS Excel - Zip File)
- 2010 Jan-Mar Hospital Inpatient Fee Schedule
- 2010 Jan-Mar Hospital Inpatient Fee Schedule (MS Excel - Zip File)
2010 New Facility Schedules
- 2010 Crystal Run Ambulatory Surgery Fee Schedule
- 2010 Physician's Choice Surgi Center Ambulatory Surgery Center Fee Schedule (2009-2010)
- 2010 Linden Oaks Surgery Center Fee Schedule
- 2010 Surgicare of Manhattan Ambulatory Surgery Fee Schedule
- 2010-11 South Shore Surgery Center Ambulatory Surgery Fee Schedule
- 2010 Rye Ambulatory Surgery Center Ambulatory Surgery Fee Schedule
- 2009 Jan-Nov Revised (12/30/11) Hospital Inpatient Fee Schedules
- 2009 Jan-Nov Revised (12/30/11) Hospital Inpatient Fee Schedules (MS Excel - Zip File)
- 2009 Revised Jan-Dec Hospital Inpatient-Chemical Dependency Detox Rates
- 2009 Apr-Dec Hospital Inpatient-Chemical Dependency Detox Rates
- 2009 Jan-Mar Hospital Inpatient-Chemical Dependency Detox Rates
- 2009 Jan-Nov Revised (5/14/10) Hospital Inpatient Fee Schedules
- 2009 Jan-Nov Revised (5/14/10) Hospital Inpatient Fee Schedules (MS Excel - Zip File)
- 2009 Dec Revised Hospital Inpatient Fee Schedules
- 2009 Dec Revised Hospital Inpatient Fee Schedules (MS Excel - Zip File)
- 2009 Dec Hospital Inpatient Fee Schedules
- 2009 Dec Hospital Inpatient Fee Schedules (MS Excel - Zip File)
2009 Revised/Updated Facility Schedules
2009 New Facility Schedules
- 2008 Dec Hospital Inpatient-Chemical Dependency Detox Rates
- 2008 July-Dec Hospital Inpatient Revised Fee Schedules (revised effective 11/13/09)
- 2008 July-Dec Hospital Inpatient Revised Fee Schedules (revised effective 11/13/09) (MS Excel - Zip File)
- 2008 July-Dec Hospital Inpatient Revised Fee Schedules
- 2008 July-Dec Hospital Inpatient Revised Fee Schedules (MS Excel - Zip File)
- 2008 Jan-Dec Hospital Inpatient Fee Schedule
- 2008 Jan-Dec Hospital Inpatient Fee Schedule (MS Excel - Zip File)
2008 Revised/Updated Facility Schedules
2008 Newly Added Facilities
- 2007 Jan-Dec Hospital Inpatient Fee Schedule
- 2007 Jan-Dec Hospital Inpatient Fee Schedule (MS Excel - Zip File)
- 2007 Jan-Dec Revised Hospital Inpatient Fee Schedule
- 2007 Jan-Dec Revised Hospital Inpatient Fee Schedule (MS Excel - Zip File)
2007 Revised/Updated Facility Schedules
2006 DRG Update
- 2006 Revised Hospital Inpatient Fee Schedule for Various Hospitals
- 2006 Revised Hospital Inpatient Fee Schedule for Various Hospitals (MS Excel - Zip File)
- DRG Update
- 2006 DRG Update (MS Excel - Zip File)
- 2006 Hospital Inpatient Fee Schedule
Effective 01/01/2006 - 12/31/2006 - 2006 Hospital Inpatient Fee Schedule (MS Excel - Zip File)
Effective 01/01/2006 - 12/31/2006 - 2006 Updated Hospital Inpatient Fee Schedule
Effective 01/01/2006 - 12/31/2006 - 2006 Updated Hospital Inpatient Fee Schedule (MS Excel - Zip File)
Effective 01/01/2006 - 12/31/2006 - Frequently Asked Questions for Subject Number 046-166 - Payments to Hospitals for Spinal Procedures
2006 Revised/Updated Facility Schedules
- 2005 Hospital Inpatient Fee Schedule - July through December
Effective 07/01/2005 - 12/31/2005 - 2005 Hospital Inpatient Fee Schedule - July through December (MS Excel - Zip File)
Effective 07/01/2005 - 12/31/2005 - 2005 Hospital Inpatient Fee Schedule
Effective 01/01/2005 - 12/31/2005 - 2005 Hospital Inpatient Fee Schedule (MS Excel - Zip File)
Effective 01/01/2005 - 12/31/2005
- 2004 Hospital Inpatient Fee Schedule - July through December
Effective 07/01/2004 - 12/31/2004 - 2004 Hospital Inpatient Fee Schedule - July through December (MS Excel - Zip File)
Effective 07/01/2004 - 12/31/2004 - 2004 Hospital Inpatient Fee Schedule
Effective 01/01/2004 - 12/31/2004 - 2004 Hospital Inpatient Fee Schedule (MS Excel - Zip File)
Effective 01/01/2004 - 12/31/2004
- 2003 Hospital Inpatient Fee Schedule - July through December
Effective 07/01/2003 - 12/31/2003 - 2003 Hospital Inpatient Fee Schedule (MS Excel - Zip File)
- 2003 Ambulatory Fee Schedule Memos
- 2003 Fee Schedule for Licensed Free Standing Ambulatory Surgery Centers
- 2003 Ambulatory Fee Schedule for Hospitals (Excel Worksheets)
- 2003 Ambulatory Fee Schedule for Surgery Centers (Excel Worksheets)
- 2003 Ambulatory Fee Schedule for Hospitals
2003 Revised/Updated Facility Schedules
2003 Newly Added Facilities (PDF files)
- All City Family Healthcare Center
- Brighton Surgery Center
- Boulevard Surgical Center
- Buffalo Surgery Center
- Cataract Center of the Adirondacks
- East Tremont Medical Center
- Eye Surgery Center of Westchester
- North Country Orthopaedic A.S.C.
- Progressive Surgery Center
- South Shore Ambulatory Surgery Center
- Specialists One-Day Surgery Center Inc.
- Sterling Surgical Center
- Suffolk Surgery Center
- Westchester Ambulatory Surgery Center