Health care providers are a critical partner in helping the injured workers of New York State get better and back to their lives! Here are important resources and requirements for treating health care providers to be aware of regarding the workers' compensation system.
Getting started
The Medical Portal is a web-based application that enables users to submit medical information and view the NYS Workers' Compensation Board (Board) information electronically. The Medical Portal is intended to create more efficient processes and enable greater levels of self-service and tracking, and ultimately improve the performance of New York's workers' compensation system overall.
Health care providers who would like to request or renew Board authorization, or use the Medical Portal to access OnBoard, MTG Lookup Tool, Drug Formulary Lookup Tool, or training will need to request a Board-assigned NY.gov user ID and password. This is separate and apart from any NY.gov account that the health care provider has created for themselves or may have for another NYS agency (for example, Department of Motor Vehicles, Tax and Finance, etc.).
Read more about the Medical Portal for Health Care Providers.
Health care providers who are eligible to become authorized must do so prior to providing clinical services for injured/ill workers. Learn which health care providers can become authorized and how to apply for authorization. Certain providers, such as dentists, are not eligible for Board authorization, but may nevertheless provide clinical services to injured/ill workers. Learn who can do what in the workers' compensation system.
Once authorized, you must renew your Board authorization at intervals which coincide with your professional license registration. Be sure to also update your authorization information whenever there is a change to your address, telephone or fax numbers, board certification status (if applicable) or professional specialty.
Providers authorized by the NYS Workers' Compensation Board to treat injured workers who wish to cease treating injured workers must submit a signed letter of resignation to the Board together with a transition plan to ensure continuity of care for injured workers under their care. Read more about what to include in the letter and where to send it.
Treating injured workers
New York Medical Treatment Guidelines (MTGs)
The Workers' Compensation Board's New York Medical Treatment Guidelines (MTGs) are the standard of care for treating individuals with work-related injuries and illnesses in New York State (NYS) and are based on the best available medical evidence and the consensus of experienced medical professionals.
You can view the current MTGs as well as FAQs and other MTG resources, including training (with CME credit for MDs and DOs), and an easy-to-use MTG Lookup Tool.
New York Workers' Compensation Drug Formulary (Drug Formulary)
Legislation enacted in April 2017 required the NYS Workers' Compensation Board (Board) to establish a drug formulary. The New York Workers' Compensation Drug Formulary (Drug Formulary) is based on a medication's effectiveness and appropriateness for the treatment of illnesses and injuries covered under the Workers' Compensation Law.
The Drug Formulary list designates drugs as either "Phase A," "Phase B," or "Perioperative." Additionally, some drugs are listed as second-line therapy and may only be used when other drugs associated with the phase of treatment have been deemed ineffective or are otherwise determined to be clinically contraindicated for a particular patient. Drugs not listed on the Drug Formulary are considered non-formulary.
Read more about the New York Workers' Compensation Drug Formulary, including application of the Drug Formulary and special considerations.
Requesting prior authorization for medical treatment/tests through OnBoard
A prior authorization request (PAR) is a request by an injured worker's health care provider to obtain prior approval from the claim administrator (e.g., insurance carrier, self-insured employer, or third-party administrator) to cover costs associated with a specific treatment under workers' compensation insurance. All PARs are submitted and reviewed online through the Board's business information system, OnBoard. Health care providers need to log into the Medical Portal to access OnBoard.
Read more about OnBoard access and administration. Read more about PAR types and how to submit a PAR. Learn more about online administration and how to assign delegate roles for OnBoard by visiting New User Access and Administration for Health Care Providers.
The Board has created OnBoard trainings to assist providers in all aspects of using OnBoard.
Treating via telehealth
Effective July 11, 2023, the Board adopted permanent regulations for telehealth appointments in certain situations for workers who sustain a work-related injury or illness. While telehealth was permitted during the COVID-19 pandemic, it was only allowed because of the institution of several emergency regulations. Now, telehealth is a permanent option within the workers' compensation system. For more information, including which provider specialties can treat via telehealth and under what conditions, see the Telehealth page.
New York State guidelines for permanent impairment and loss of wage-earning capacity
The Board has published two separate guidance documents (2012 and 2018 ) related to the determination of permanent impairment and/or loss of wage-earning capacity. The Board has created trainings on the NYS Guidelines for Determining Impairment and Loss of Wage-Earning Capacity.
Billing for services
Who can bill?
Board-authorized providers can bill for services in treating injured workers. Certain specialties can treat, but must bill through their supervising provider. Please visit the Who can bill webpage for full details.
Medical fee schedules
Recent changes to the Board's medical fee schedules have brought workers' compensation rates more in line with other insurances. The Official New York Workers' Compensation Medical Fee Schedule may be purchased or can be reviewed in person 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.
CMS-1500 form
The New York State workers' compensation system now uses the universal billing form, CMS-1500, for medical billing. The Board has developed a Medical Narrative Report Template that can be used to create the medical narrative report that accompanies provider submissions of the CMS-1500 form. The template includes at the top of the page the three elements to include with most narratives: the patient's work status, causal relationship of the injury to the patient's work activities, and temporary impairment percentage. A medical narrative report may be found legally defective if these elements are missing. However, payers should not use the absence of these three elements as the sole basis for denying reimbursement as there are some instances in which they are not required.
Effective August 1, 2025, providers are required to partner with a CMS-1500 electronic submission partner who will ensure that the medical bill and narrative attachment are sent and accepted by the correct payer. Read more about the CMS-1500 submission process.
Medical billing issues/disputes
If an insurance carrier has not paid your bill in full within 45 days of submission, you may be able to request the Board's assistance by filing Form HP-1.0 through OnBoard.
Read more about requesting assistance with unpaid medical bills, filing Enforcement on Failure to Pay Award or Judgment (Form HP-J1), and billing for medical testimony on the Medical Billing Disputes page.
For more information on medical bill disputes, please call (800) 781-2362.
Resources
Webpages
Health care providers
Paid Family Leave Information for Health Care Providers
What providers need to know webinars
The Board regularly offers webinars for providers, to share important updates related to treating injured workers in the NYS workers' compensation system. Visit the Upcoming Webinars page to view the schedule of planned events or visit Recorded Webinars to view a recently recorded session.
WCB notifications
To stay informed on important updates from the Board, sign up to receive WCB notifications . This will send Board news straight to your email inbox. You can choose to subscribe for alerts on the topics you care most about.
Provider updates
Governor Hochul fighting for historic change to increase injured workers' access to medical treatment
Governor Kathy Hochul is proposing new legislation to allow any eligible licensed medical provider in good standing to treat workers' compensation patients.
Today, most provider disciplines must be Board-authorized to treat injured workers. Of the more than 200,000 eligible providers statewide, only about 10 percent have taken the steps to become Board-authorized, which significantly limits access to care, especially in rural areas. Under the Governor's proposal, authorization would be automatic as part of a health care provider's state licensing. Injured workers would be able to seek treatment from a provider of their choice (potentially even their own primary care physician), if the provider is willing to treat them.
For more information about the universal authorization proposal, visit 2026 State of the State Proposal: Universal Authorization.
Give your feedback on the Governor's proposal to increase injured workers' access to health care through universal authorization. Your input may be made public on our page and social media. Write to publicinfo@wcb.ny.gov to share your thoughts.
Read more in the Press Release dated March 17, 2026.
New discipline-specific webpages
Each discipline-specific web page is organized to give providers quick, role-specific information about Board authorization requirements and scope of practice.
These pages delve into treatment standards under the New York Medical Treatment Guidelines (MTGs), telehealth rules and required in-person visit intervals, where applicable. These webpages show which prior authorization requests (PARs) each discipline can submit, billing requirements, including information on CMS-1500 electronic submission as well as direct links to training, webinars, and additional provider resources.
Access the new discipline-specific pages via the Board's Who Can Treat page. We will be updating the pages over time, so check back!
New inbox for health care provider feedback
The Board has also established a new email for provider feedback, giving you a direct and convenient way to share your experiences, concerns, and suggestions: HCPFeedback@wcb.ny.gov
Note this email account is different from the providers@wcb.ny.gov email that health care providers can use for help with specific issues, or to reply to credentialling and or compliance-related communications.
Whether you have input or questions regarding Board processes, training resources, or ideas for how we can improve your overall provider experience, your feedback is extremely valuable to us, and we want to hear from you.
Your submissions may be shared with appropriate internal teams to review and address trends or reoccurring concerns. Individual responses will be provided when follow-up is requested, and contact information is included.
Use HP1.0 process for CMS-1500 electronic submission offset billing disputes
Under the Board's CMS-1500 electronic submission mandate, providers may offset the cost of each electronic CMS-1500 bill submission, up to a maximum of one dollar, by using CPT code 99080. Payers who do not pay the offset may be subject to penalties from the Board.
Effective March 31, 2026, if a bill for services is paid (in full or in part) but the offset is not, providers may file a Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0).
Read more in notification dated February 26, 2026.
Faxed claim-related form submissions (including IME reports) no longer accepted as of April 1, 2026
In January, the New York State Workers' Compensation Board (Board) announced that effective April 1, 2026, faxed submissions of claim-related documents will no longer be accepted. This includes independent medical examination (IME) reports.
Read more in notification dated March 12, 2026.
Webinar series: What Providers Need to Know
The Board is pleased to continue our webinar series for health care providers who treat New York State's injured workers. The sessions cover legislative and regulatory updates, recent and planned improvements, and more. For those who were unable to attend the February session, you can view the recording on our Recorded Webinars section of the website.
The next provider webinar is scheduled for May 12, 2026. Read more in notification dated January 27, 2026 or visit the Upcoming Webinars page on our website to register.
We want to hear from you!
The Board is committed to keeping stakeholders informed of important Board news, policy and program updates, system enhancements, and best practices to improve your experience.
Are you happy with the information you receive via WCB Notifications, or do you have suggestions on how we can improve? We want your feedback! Please share your thoughts through this brief, three-minute survey:
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Reminders
- Electronic submission of the CMS-1500 form is mandatory. Visit the CMS-1500 initiative page for more details and send your questions to CMS1500@wcb.ny.gov.
- Interested in treating injured workers? If you are interested in applying for Board authorization to treat injured workers, the process is easy and is done online. Read more about becoming authorized on the Board's website.
- The What Providers Need to Know section of the Board's website features a one-stop-shop that walks health care providers through getting started in the workers' compensation system, treating injured workers, billing for services, and more.
- Visit the Board's website for OnBoard training guides, webinar recordings, and other resources.
- Efficiency Enhancements is a quarterly bulletin with tips and best practices on using Board systems, processes, and forms in the most efficient, effective manner. Sign up to receive these, and other updates, straight to your inbox.
- The latest versions of several Paid Family Leave presentations are available, including family care, foster care/adoption, military leave, and bonding. Visit the Paid Family Leave website for more information.
Stay informed!
Check out Recorded Webinars for health care providers on the Board's website. Health Care Providers Recorded Webinars web page for past webinars.
To receive notifications from the Board straight to your inbox, subscribe for Board updates .
Archived Updates
Contact the Medical Director's Office (MDO)
If you have a question for the MDO, you can quickly reach us via: