How Often Do States Update Their Workers’ Comp Fee Schedules?

How Often Do States Update Their Workers’ Comp Fee Schedules?

Introduction

Medical pricing evolves constantly, and workers’ compensation systems must keep pace to maintain fair reimbursement while controlling costs. Update frequency varies by state, depending on how closely the fee schedule is tied to Medicare.

Update Frequency by State

1. California

Updates multiple times per year, including:

• Physician services

• DME

• Pharmacy

• Hospital inpatient/outpatient

It’s one of the most active update cycles in the country.

2. Texas

Texas updates annually, following Medicare RBRVS changes.

3. Washington

Updates yearly through its state-run L&I system.

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4. Massachusetts

Updates periodically — sometimes annually, sometimes less often.

5. Other States

Most update every 12–36 months, depending on budget cycles.

Why Regular Updates Matter

1. Aligning with Medical Inflation

Helps maintain fair reimbursement.

2. Ensuring Accurate Pricing for New Procedures

New CPT codes require updated fee values.

3. Controlling Excessive Costs

Frequent updates prevent outdated pricing.

Conclusion

Update frequency varies widely, but states tied closely to Medicare generally revise their fee schedules more often. Regular updates help maintain fairness and cost stability across the system.