IBR update 2019

Applications Filed

IBR Total Filing chart

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
Physician Services 666
Hospital Outpatient Departments and Ambulatory Surgical Centers
156
Medical-Legal Fee Schedule 128
Contract for Reimbursement Rates 93
Inpatient Hospital Services 87
Pathology and Laboratory Services 46
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
17
Pharmaceutical 4
Ambulance Services 1
Interpreter 1

Case Outcomes

  • 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.

IBR Case Outcome

September 2019