Statutes, codes, and regulations
Wyoming Administrative Code
Agency 053 - Workforce Services, Department ofSubagency 0021 - Workers' Compensation Division
Chapter 9 - FEE SCHEDULES
Section 9-2 - Fee Schedules

053-9 Wyo. Code R. § 9-2

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Current through April 27, 2019
Section 9-2 - Fee Schedules

(a) The Division adopts Relative Values for Physicians (RVP) (2018 ed.), as published by Optum 360, LLC, as authored by Relative Value Studies, Inc., insofar as it addresses medical matters under the Act unless otherwise defined in this chapter. The Division adopts Relative Values for Dentists (RVD) (2018 ed.), as published and authored by Relative Value Studies, Inc., Thornton, Colorado, insofar as it addresses dental matters under the Act.

  • (i) The Division has determined that incorporation of the full text in these rules would be cumbersome or inefficient given the length or nature of the rules;
  • (ii) The incorporation by reference does not include any later amendments or editions of the incorporated matter beyond the applicable date identified in subsection (a) of this section;
  • (iii) The incorporated code, standard, rule or regulation is maintained at 1510 East Pershing, Cheyenne, WY 82002 and is available for public inspection and copying at cost at the same location.

(b) Each code incorporated by reference in these rules is further identified as follows:

  • (i) Relative Values for Physicians (RVP) and Relative Values for Dentists (RVD), (2018 ed.), as they were in effect on January 1, 2018, and adopted by the Department of Workforce Services, Wyoming Workers' Compensation Division.

(c) Conversion Factors. The Division adopts the following conversion factors.

SPECIALTY GROUP CONVERSION FACTOR
Anesthesia $ 51.12
Surgery $ 120.21
Radiology/Nuclear Medicine $ 21.97
Pathology/Laboratory $ 15.23
Medicine $ 7.91
Physical Medicine and $ 6.39
Evaluation and Management $ 8.34
Dental $ 55.73

(d) Fees for Surgery.

  • (i) Surgical Assistants.
    • (A) MD assistants shall be paid 20% of the surgical allowance.
    • (B) Non-MD assistants shall be paid 15% of the surgical allowance.
  • (ii) Capsular Shrinkage Procedure. (Multiple procedure guidelines apply).

    Description Unit
    Shoulder 16.4
    Elbow 13.8
    Wrist 10.7
    Hip 15.6
    Knee 17.6
    Ankle 12.0

(e) Fees for Independent Medical Evaluations (IME), Permanent Partial Impairment Ratings (PPI), Medical Testimony and Deposition(s). See Chapter 10, and Chapter 9, Section 1 for additional guidelines. Medical bills must indicate total time spent on review of records, actual examination and writing of the report. The medical report must include a breakdown of the total time spent. Medical bills must also include time spent on travel, if applicable.

  • (i) Independent Medical Evaluations or Impairment Ratings. The Division shall pay according to the following fee schedule:

    Code Time Payment
    99455-99456 1st hour $500.00
    Each additional 15 minutes $ 62.50

  • (ii) Medical Testimony and Deposition Charges. The Division shall pay according to the following fee schedule:

    Code Time Payment
    99075 1st hour $500.00
    Each additional 15 minutes $ 62.50

053-9 Wyo. Code R. § 9-2

Amended, Eff. 12/12/2017.

Amended, Eff. 5/23/2018.