Provider Updates

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

Signing up for the Medical Portal

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.

Board authorization

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

Injured Worker

Treatment

Medications

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

Medical Fees

Forms

Medical billing

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

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. The Board will post a recording for those unable to attend a live session.

Read more in notification dated on January 27, 2026 or visit the Upcoming Webinars page on our website to register.

Proposed Medical Fee Schedule updates now available for public comment

The Chair proposes amendments to Sections 329-1.3, 329-4.2, 333.2, 343.2, and 348.2 of Title 12 of the NYCRR to update the Official New York Workers' Compensation Medical Fee Schedule, the Official New York Workers' Compensation Acupuncture and Physical Therapy and Occupational Therapy Fee Schedule, the Official New York Workers' Compensation Behavioral Health Fee Schedule, the Official New York Workers' Compensation Podiatry Fee Schedule, and the Official New York Workers' Compensation Chiropractic Fee Schedule.

Proposed Depositions regulation now available for public comment

The Chair proposes amendments to Sections 301.1, 301.3, and 300.10 of Title 12 of the NYCRR to update the depositions process and fees.

Proposed regulation with billing guidance for residents and fellow physicians now available for public comment

In 2025, an amendment to Section 13-b of the New York State Workers' Compensation Law went into effect, extending the ability of resident and fellow physicians to treat injured workers (under the supervision of an authorized physician). In December 2025, the Chair of the NYS Workers’ Compensation Board proposed amendments to help implement this law by providing guidance about billing procedures for services performed by residents and fellows.

Now available! New and improved Fundamentals for Health Care Providers

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