Mississippi Administrative Code
Title 20 - Labor
Part 2 - Mississippi Workers' Compensation Medical Fee Schedule
INTRODUCTION

Pursuant to Mississippi Code Annotated (MCA), § 71-3-15(3)(Rev. 2000), the following Fee Schedule, including Cost Containment and Utilization Management rules and guidelines, is hereby established in order to implement a medical cost containment program. This Fee Schedule, and accompanying rules and guidelines, applies to medical services rendered after the effective date of June 15, 2019, and, in the case of inpatient treatment, to services where the discharge date is on or after June 15, 2019. This Fee Schedule establishes the maximum level of medical and surgical reimbursement for the treatment of work-related injuries and/or illnesses, which the Mississippi Workers' Compensation Commission (MWCC) deems to be fair and reasonable. Reimbursement for professional fees is based on Medicare Relative Value Unites (RVUs) effective Janaury 1, 2019.

Updates and changes before the periodic update can be found by checking the State of Mississippi Workers' Compensation Commission websitehttp://www.mwcc.state.ms.us/#/home [File Link Not Available] or the FAIR Health website at https://orders.fairhealth.org [File Link Not Available]Subscribers should regularly check these sites for changes. Providers can also provide their contact information on the MWCC website at https://mwcc.gov [File Link Not Available]to be notified of important updates in the future.

This Fee Schedule shall be used by the MWCC, insurance payers, and self-insurers for approving and paying medical charges of physicians, surgeons, and other qualified health care professionals for services rendered under the Mississippi Workers' Compensation Law. This Fee Schedule applies to all medical services provided to injured workers by physicians, and also covers other medical services arranged for by a physician. In practical terms, this means professional services provided by hospital-employed physicians and other qualified health care professionals, as well as those practicing independently, are reimbursed under this Fee Schedule.

The MWCC will require the use of the most current CPT®, CDT, and HCPCS codes and modifiers in effect at the time services are rendered. All coding, billing and other issues, including disputes, associated with a claim, shall be determined in accordance with the CPT, CDT and HCPCS guidelines and National Correct Coding Initiative (NCCI) coding edits in effect at the time service is rendered, unless otherwise provided in this Fee Schedule or by the MWCC.

As used in this Fee Schedule, CPT refers to the American Medical Association's Current Procedural Terminology codes and nomenclature. CPT is a registered trademark of the American Medical Association. CDT refers to the American Dental Association's Current Dental Terminology (CDT) codes. CDT is a registered trademark of the Amercian Dental Association. HCPCS is an acronym for the Centers for Medicare and Medicaid Services' (CMS) Healthcare Common Procedure Coding System. HCPCS is divided into two subsets. HCPCS Level I codes are the CPT codes developed and maintained by the AMA. HCPCS Level II codes are developed and maintained by CMS and include codes for procedures, equipment, and supplies not found in the CPT book and are referred to in this Fee Schedule as HCPCS codes.

The inclusion of a service, product, or supply identified by a CPT, CDT, or HCPCS code does not necessarily imply coverage, reimbursement or endorsement.