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You are here: Home . bulletins . 2014 . b-0023-14

Commissioner's Bulletin # B-0023-14

December 02, 2014

To: Workers' Compensation System Participants Implementation

Re: Annual Change to the Medical Fee Guideline Conversion Factors as Established in Title 28 Texas Administrative Code (TAC) ยง134.203

The purpose of this bulletin is to inform workers' compensation system participants of the annual change to the Medical Fee Guideline conversion factors as established in 28 TAC §134.203.  Under Labor Code §413.011(a), fee guidelines adopted by the Division of Workers' Compensation (DWC) for non-network services and approved out-of-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.

To provide predictability and reflect changes in medical service delivery costs to system participants, DWC established a conversion factor and an annual update as a part of 28 TAC §134.203(c). The annual update is based on the Medicare Economic Index (MEI), which is a weighted average of price changes for goods and services used to deliver physician services. The MEI for 2015 reflects an increase of 0.8 percent.

For services provided in calendar year 2015, the new Medical Fee Guideline conversion factors are $56.20 and $70.54. The conversion factor of $56.20 applies to service categories of evaluation and management, general medicine, physical medicine and rehabilitation, radiology, pathology, anesthesia, and surgery when performed in an office setting. The conversion factor of $70.54 applies to surgery when performed in a facility setting.

If there are any questions about the information in this bulletin, call the toll-free Comp Connection for Health Care Providers at 1-800-372-7713.

W. Ryan Brannan

Commissioner of Workers' Compensation

For more information contact:

Last updated: 12/09/2014

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