Filed as: Labor and Management Division, Workers Compensation Rules - Revise Medical Fee Schedule
Medical providers treating workers' compensation injuries will see changes to how they are reimbursed under South Dakota's fee schedule, which now adopts the 2025 version of the Relative Values for Physicians instead of the 2020 version. The multiplier rates used to calculate payments have been updated for several procedure codes—notably, evaluation and management services in the 99201-99450 and 99460-99499 ranges will increase from $8.00 to $12.00 per base unit value. Insurance companies and self-insured employers will need to obtain the updated fee schedule from Relative Value Studies, Inc. at a higher cost ($1,500 base plus $40 per user, up from $329.95), and the rule also refines technical definitions to clarify how reimbursement eligibility and calculation of services with no established values work.
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Revised the workers’ compensation medical fee schedule by adopting the 2025 version of the Relative Values for Physicians and updating selected billing code multipliers.
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