Huge Regulatory Win Closes Successful Year of Physician Advocacy

Starting in 2013, physicians will be compensated more fairly when they provide care to North Carolina’s sick and injured workers.  Physicians will see a 30 percent increase on new- and established-patient office visits (CPT codes 99201-99205 and 99211-99215) and a 5 percent increase on all physical medicine services, including PT and occupational therapy. 

And despite significant pressure to offset the increases by cutting doc pay in other areas, such as surgery and imaging, the NCMS was there to ensure that all other physician services were protected from decreases. 

The changes were finalized today when the North Carolina Industrial Commission completed work on its Fee Schedule Rule.  NCMS worked closely over the last several months with Industrial Commission Chair Pam Young and Commissioner Staci Meyer, and the worker and business communities to negotiate the changes.  Members of the NC Medical Group Managers were also instrumental in the effort.

“These new rates will bring welcomed relief to physicians who have struggled over the years to maintain a workers’ compensation practice, said Richard Bruch, MD, an orthopedic surgeon and Chair of the NCMS Workers’ Compensation Task Force.  “The Commission has removed a huge barrier for injured workers to access quality medical care that they need to get healthy and return to work.  I urge my physician colleagues who have previously been unable to serve our injured workers to take the opportunity to reconsider,” Dr. Bruch added.

Payments for these fundamental services have almost always been undervalued by the state, which is responsible for periodically reviewing and revising a comprehensive physician fee schedule for workers’ compensation.

“This addresses a seventeen-year-old problem and will benefit a huge percentage of North Carolina physicians and their patients,” said NCMS President Mike Moulton, MD.  “This demonstrates how the NCMS is well-positioned to recognize opportunities and work effectively on behalf of the medical profession.  It’s a great note for doctors and the NCMS to end the year on.”

The only remaining question is precisely when in 2013 the revised rates will take effect.  NCMS will be pushing for a January effective date and will notify members when that information becomes available.