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COMMISSIONER'S BULLETIN # B-0075-08

November 20, 2008


To: Workers' Compensation System Participants


Re: Changes to Conversion Factors for Workers' Compensation Medical Fee Guidelines 28 TAC §134.203 Medical Fee Guidelines for Professional Services Chapter 134 - Benefits - Guidelines for Medical Services, Charges and Payments Subchapter C. Medical Fee Guidelines

The purpose of this bulletin is to inform system participants of the annual change to the Medical Fee Guideline conversion factors as established in 28 TAC §134.203. As directed by Texas Labor Code §413.011(a), fee guidelines adopted by the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) for non-network services are based on the most current reimbursement methodologies, models, and values or weights used by the Federal Centers for Medicare and Medicaid Services (CMS).

In order to provide predictability and reflect changes in medical service delivery costs to system participants, TDI-DWC established a conversion factor and an annual update as a part of §134.203. The annual update is based on the Medicare Economic Index (MEI), which reflects price changes for goods and services used to deliver physician services. The MEI, reported as 1.6% increase for 2009, is a weighted average of price changes for goods and services used to deliver physician services. The following link provides further detail regarding the MEI: http://www.cms.hhs.gov/PhysicianFeeSched/PFSFRN/itemdetail.asp?filterType=none&filterByDID=0&sortByDID=4&sortOrder=descending&itemID=CMS1216674&intNumPerPage=10

Consequently, for services provided in calendar year 2009, the new Medical Fee Guideline conversion factors in §134.203(c) are $53.68 and $67.38. The conversion factor of $53.68 applies to service categories of Evaluation & Management, General Medicine, Physical Medicine and Rehabilitation, Radiology, Pathology, Anesthesia, and Surgery when performed in an office setting. The conversion factor of $67.38 applies to Surgery when performed in a facility setting.

If there are any questions regarding the information in this bulletin, please contact Ruth Richardson, Manager of Healthcare Policy and Implementation, at (512) 804-4850 or send email to: MedBen@tdi.state.tx.us.

Rod Bordelon
Commissioner of Workers' Compensation
Texas Department of Insurance



Last updated: 09/07/2014

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