IBR update 2019
Applicable Fee Schedule
This is the DWC fee schedule that covers the service for the disputed bill and is used by the IBRO to decide the appropriate reimbursement. Contracts between providers and payers may supersede the DWC fee schedules and are considered separately by the IBRO.
|Applicable Fee Schedule||Count|
|Medical-Legal Fee Schedule||128|
|Contract for Reimbursement Rates||93|
|Inpatient Hospital Services||87|
|Pathology and Laboratory Services||46|
- Overturned – The IBRO has determined that additional reimbursement is warranted.
- Upheld – The IBRO has determined that no additional reimbursement is warranted.
There have been 1,100 case decisions issued in 2019 (through August 31). The 559 overturned cases issued since January 1, 2019 total $1,055,600 in additional reimbursement to the IBR applicants.