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Medicare Fee Schedule

The District of Columbia Workers’ Compensation Act, DC Code, as amended, § 32-1507(a-1) (5) provides in pertinent part:

Each provider of medical care or services pursuant to this chapter shall use a standard coding system for reports and bills generated pursuant to this chapter.  Medical care and services shall be billed at the rate established in the medical fee schedule adopted by the Mayor.  This fee schedule shall be based on 113 percent of Medicare’s reimbursement amounts. 

In light of the above, it is clear that the reimbursement of medical care and services causally related to a work injury must be guided by the comprehensive Medicare reimbursement schedules maintained and updated by the Center for Medicare and Medicaid Services. 

Medicare Fee Schedule