2024 worker's compensation fee schedule

Table A, Part I: Prospective Payment System

NPI or Provider #

Provider #

Indirect Medical Education Add-On

Direct Medical Education Add-On

Disproportionate Share Add-On

Paramedical Education Add-On

Aggregate RCC

DRG Rate

Capital Rate

Hold Harmless Rate

  Implied Decimal 6 (in percentages)Implied Decimal 4 (in percentages)Implied Decimal 6 (in percentages)Implied Decimal 2 (in dollars)
112440559239000136081155916463627748519890528423235175471
125554064739000136081155916463627748519890528423235175471
128503212839000136081155916463627748519890528423235175471
132644625339000136081155916463627748519890528423235175471
133652627639000136081155916463627748519890528423235175471
136644450739000136081155916463627748519890528423235175471
141733435039000136081155916463627748519890528423235175471
146785014939000136081155916463627748519890528423235175471
149713233639000136081155916463627748519890528423235175471
154864827239000136081155916463627748519890528423235175471
177096013039000136081155916463627748519890528423235175471
197265206339000136081155916463627748519890528423235175471
11947347983900021354685293241405518331006201951120
19423648983900021354685293241405518331006201951120
1821198755390003002970579483905284884310
1841408739390003002970579483905284884310
1891852703390003002970579483905284884310
18816902123900040001397498517976238778030
101338480939000626365710759344415014508391905284785100
103349174139000626365710759344415014508391905284785100
106354001139000626365710759344415014508391905284785100
106370850139000626365710759344415014508391905284785100
115461769439000626365710759344415014508391905284785100
123521542739000626365710759344415014508391905284785100
124563223139000626365710759344415014508391905284785100
127583216439000626365710759344415014508391905284785100
127585062039000626365710759344415014508391905284785100
141723193739000626365710759344415014508391905284785100
142734496939000626365710759344415014508391905284785100
145765034339000626365710759344415014508391905284785100
146774847539000626365710759344415014508391905284785100
152819772039000626365710759344415014508391905284785100
165976286239000626365710759344415014508391905284785100
166976828939000626365710759344415014508391905284785100
177087921539000626365710759344415014508391905284785100
185150816239000626365710759344415014508391905284785100
198203796639000626365710759344415014508391905284785100
198298840839000626365710759344415014508391905284785100
1861435042390009352621638128316884388855928272986520
138689630639001200006813841101073980170
11240760393900130000770580901697611470
1477538312390016003834640564555510062011029720
143786595339002610286344440007009741101073782680
196257902939002736919716442637351000346350110107352243236563
15685261353900282126701050916381996940741810062011092070
18816951463900282126701050916381996940741810062011092070
123513840539003000036715651378901697911640
1689679581390032000670251196310062011029720
1669405072390035000036110711010731121390
10634220533900363942727555096953767410062014737685653
15887704163900370004330063515810062011058310
10735984393900370004330063515810062011058310
1912900168390039008252588541040918172979860
1871594127390041008412376949671610062011029720
1609984889390042432093091225642196010062011029720
16695300693900448497123313021042468000942514818980
16098019763900454446721869287564040200089002618255144847
1326060492390046144496641172595922604415931416733090
160926394639004882403457800770000901697891260
163956055039004882403457800770000901697891260
168906192139004882403457800770000901697891260
175077898139004882403457800770000901697891260
186154568339004882403457800770000901697891260
10139331753900496865632236013379860763010272281020070
15482939543900496865632236013379860763010272281020070
19523999333900496865632236013379860763010272281020070
1285667493390050248542777345343112387091100620151803129032
1700878840390056000059727990169713056205948
1568459287390057000045059311010731210730
16891073283900580003047554630976238814000
14977084733900620000734000945733935860
148764759039006352946325835396973397020928272938460
1265466957390065000073643110986681119130
1407928500390066393531725500492272976238759740
1407813603390067130828526744332232445000976238869100
128516791639006858594330768540193955955907977050
152831962139007091532964004314801101073644800
18417128823900710000686000901697897440
1316919699390072007100519617905284837800
1649278730390073379413097441025331446000945733955930
10836143823900791121083734602018463494590169730383183243
11347345283900791121083734602018463494590169730383183243
1548624851390081299620003519531101073794650
1144249657390086004000677485901697891330
1316537228390086004000677485901697891330
1194744805390090174532607626493707335655410062011029720
16190694403900910003356597181901697957480
12654229013900933041120351006207849016976790132162
1699734665390096263673329885932195281379425143221989240
17503715223900970005703570271101073993490
11048751033901005691018259019607724335955907702680
12455719423901005691018259019607724335955907702680
106394570739010192128523813900497259931416666430
175044560739010211084111643701469146251410062011098550
179079535939010211084111643701469146251410062011098550
186147830739010400000993413911640
122504769939010700005605691006201814320
163921893639010700005605691006201814320
1801897038390110126380685846903735941692590363830795123321
185137091039011153930531321115857937321731110107329122376876
127562053639011200006076049036389439108767
19422764233901130010000802026921870818180
165943550139011414799511063317020479453100620142687173018
195231150839011414799511063317020479453100620142687173018
1114095791390115606424121767131461288789110107361641107806
1205904885390115606424121767131461288789110107361641107806
1215952106390115606424121767131461288789110107361641107806
1801963343390115606424121767131461288789110107361641107806
1124495239390116219851954432688944495201101073117834174181
12957241933901170000726684901697732870
15785698853901180000414013901697781960
19223761363901192471627385004280109052847988162588
164979442139012300004750551101073977920
11240261823901250000562680901697911640​