New York State's injured workers need you!
Each year, more than 150,000 New Yorkers are injured or become ill on the job. These workers need and deserve accessible, high-quality medical care to recover, return to their work, and get back to their lives.
Becoming a NYS Workers' Compensation Board-authorized provider allows you to care for injured workers and support New York's workforce.
Who can be authorized
As of January 1, 2020, providers who can be authorized must be authorized to treat injured workers. The following medical provider types may be authorized to treat injured workers in the NYS Workers' compensation system:
- Acupuncturists
- Chiropractors
- Licensed Clinical Social Workers
- Nurse Practitioners
- Occupational Therapists
- Physical Therapists
- Physicians
- Physician Assistants
- Podiatrists
- Psychologists
Note: If your specialty is not listed, you cannot be authorized, but you may still be permitted to treat injured workers. See the Who Can Treat? page for details. Out-of-state providers do not need Board-authorization, but must be eligible under the permitted provider categories.
When authorization is required
Most providers must be Board-authorized before treating injured workers in the NYS workers' compensation system. Authorization ensures providers understand workers' compensation requirements and can deliver care effectively and efficiently within the system.
In an emergency, an injured worker may seek immediate treatment from any medical provider, regardless of authorization status. Board authorization is required for continued, non-emergency treatment within the NYS workers' compensation system.
How to apply for authorization
The authorization process is completed online through the NYS Workers' Compensation Board Medical Portal in three steps.
- Sign up to access the Medical Portal
Sign up to use the NYS Workers' Compensation Board Medical Portal and/or login with the credentials that have been assigned to you. You will need this to access the online form to apply for Board authorization. To access the Medical Portal, you must have an NY.gov ID. This is not the personal NY.gov ID that you may have with other agencies, such as the Department of Motor Vehicles, Department of Taxation and Finance, etc. The NY.gov User ID and temporary password will be generated for you when you submit a request for Medical Portal access. More information is available on the Medical Portal Access and Administration web page. - Review the NYS Workers' Compensation Fundamentals for Health Care Providers webpage
The NYS Workers' Compensation Fundamentals for Health Care Providers webpage includes brief training topics/resources as well as a summary of provider obligations. You can review this content from this right page or within the Medical Portal (under Medical Provider, select Training, and then NYS Workers' Compensation Fundamentals for Health Care Providers). - Complete the new Provider Authorization Request
Once you've reviewed the NYS Workers' Compensation Fundamentals for Health Care Providers, you can begin the New Provider Authorization Request online application form, which you can access from the Medical Portal login. Because the application must be done in a single sitting (you can't save and come back later), it is important to have the following information readily available before you begin:- Your individual National Provider Identifier (NPI)
- Mailing and practice address(es)
- NYS license number(s)
- Board certification(s), if applicable
- Certificate of completion of an approved residency program (if you have completed a residency)
- Disciplinary information
- Curriculum vitae/resume
- (Physician Assistants Only) Supervising Physician Affirmation Letter - this must be completed by your supervising physician and attached to your application
Important notes for physicians
Certificate of completion of an approved residency program
Physician applicants for authorization to treat injured workers must demonstrate that they qualify for a specialty rating. This requirement can be satisfied in one of three ways:
- Currently active certification in the medical specialty for which the physician has applied, by a member board of the American Board of Medical Specialties or the American Osteopathic Association, and for those physicians subject to periodic recertification or maintenance of certification requirements, demonstration that the physician is participating in maintenance of certification, or
- Completion of a residency or fellowship accredited by the Accreditation Council on Graduate Medical Education or American Osteopathic Association, in the medical specialty for which the physician has applied, or
- Completion of a residency accredited by CanERA (Canadian Excellence in Residency Accreditation) or one of its recognized historic residency accreditation equivalents (e.g., the Royal College of Physicians and Surgeons of Canada) that would satisfy the training requirements of a member board of the American Board of Medical Specialties or American Osteopathic Association.
Review by medical society
Applications submitted by physicians are initially reviewed by the medical society of the county where the physician's office is located.
When completing the online application, you will be asked which county medical society you want to send the application to for review. This should be the county where you practice the majority of your time.
The medical society you submit your application to may, at its discretion, charge a fee to process your application. Contact the appropriate medical society for additional information.
After the medical society submits their recommendation to the Board, it will be reviewed, and you will be advised of the final authorization determination.
Training for new providers
Before applying for authorization, new providers should review the NYS Workers' Compensation Fundamentals for Health Care Providers. This webpage provides an overview of provider responsibilities and high-level training on medical treatment guidelines, billing basics, and key requirements for participating in the workers' compensation system. Reviewing this information in advance will help ensure a smoother application process and successful participation once authorized.
Why consider workers' compensation?
You can make a real impact
Helping injured workers recover and return to work, when possible, benefits:
- Your practice
- Workers and their families
- Employers
- Local communities
- New York's economy
Your patients get continuity of care
If your patient is injured on the job, being authorized allows you to continue treating them, ensuring care is coordinated, comprehensive, and centered on the person. This is especially important for patients dealing with other medical conditions, so care can be considered in the context of the whole person, not an isolated diagnosis.
Compensation is competitive
Recent updates to our fee schedules mean that workers' compensation reimbursement rates are now significantly higher than Medicare and more competitive than ever.
It's simpler than you think
In recent years, workers' compensation has become much easier to navigate:
- All the old billing forms have been replaced with the CMS-1500 universal billing form, the same form you use for other payers, for easier administration.
- These bills are submitted electronically, providing for increased accuracy, efficiency and timely payment.
- Deposition testimony is rarely required, and when needed, it's reimbursed well and done entirely by phone.
- Most treatments don't require prior authorization, but where required, they are expedited via an online submissions process with an easy-to-use dashboard for tracking the status of your requests; and you can assign delegates to much of the work for you.
- There are online treatment lookup tools and other resources to make treating injured workers easier than it has ever been.
- Any medical billing disputes are submitted online and resolved faster than ever before.
Partnering with providers
The New York State Workers' Compensation Board is committed to partnering with health care providers to support high-quality care for injured workers.
We engage with providers through:
- Frequent communication and outreach regarding program updates and improvements.
- Webinars and Q&A sessions covering policy changes, billing updates, and clinical topics.
- Continuing Medical Education (CME) and other training opportunities.
- Medical Director's Office support to answer questions and resolve issues.
Our goal is to make participation in the workers' compensation system as clear, efficient, and provider-friendly as possible, so providers can focus on delivering high-quality care to New Yorkers.
Apply for authorization
Contact
If you have any questions about the application process, please call the Medical Director's Office at (800) 781-2362, or send an email to provider@wcb.ny.gov.