You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.
Skip Ribbon Commands
Skip to main content
Turn off Animations
Turn on Animations
An Official
Pennsylvania
Government Website
Translate
DLI
Department of Labor & Industry
I am ...
I am ...
Claimant
Worker
Employer
Researcher
Provider
Services
Services
Unemployment Benefits
Unemployment Tax Services
Workers' Compensation
Disability Determination
Job Search & Career Training
Disability Services
Labor Law Compliance
Occ. & Industrial Safety
Document Downloads
Labor Market & Jobs Data
Divisions
Divisions
Unemployment Compensation
Unemployment Tax Services
Workers' Compensation
PA CareerLink®
PennSERVE
Vocational Rehabilitation
Work Statistics
Labor Law Compliance
Occ. & Industrial Safety
Disability Determinitation
About
About
Contact the Pennsylvania Depar
Equal Opportunity
Guide to Services
Boards
Councils and Committees
Right to Know
Search
Search
Menu
Department of Labor & Industry
Menu
I am ...
I am ...
Claimant
Worker
Employer
Researcher
Provider
Services
Services
Unemployment Benefits
Unemployment Tax Services
Workers' Compensation
Disability Determination
Job Search & Career Training
Disability Services
Labor Law Compliance
Occ. & Industrial Safety
Document Downloads
Labor Market & Jobs Data
Divisions
Divisions
Unemployment Compensation
Unemployment Tax Services
Workers' Compensation
PA CareerLink®
PennSERVE
Vocational Rehabilitation
Work Statistics
Labor Law Compliance
Occ. & Industrial Safety
Disability Determinitation
About
About
Contact the Pennsylvania Depar
Equal Opportunity
Guide to Services
Boards
Councils and Committees
Right to Know
I am a(n)...
Find Services
Bureaus & Offices
Make a Payment
Contact Us
Publications
DLI
>
Businesses
>
Workers' Compensation Services
>
Workers' Compensation
>
Health Care Services Review
>
Medical Fee Review
>
Fee Schedule
>
Fee Schedule A Part II
Begin Main Content Area
Page Content
Content Editor
2024 Workers' Compensation Fee Schedule
Table A: 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)
1750805552
390127
0
0
0
0
633294
1101073
123001
0
1184620486
390130
0
0
0
0
672000
903638
63039
0
1164400131
390133
96119
30636
0
2145
517000
1027228
93575
0
1255585303
390137
23063
14230
635
0
455845
905284
88779
0
1821091059
390138
0
0
0
0
791148
901697
65100
0
1508971441
390139
70978
34408
0
4335
408291
1101073
106981
0
1902805245
390142
369904
212140
1506
4035
365688
1101073
260530
0
1689691214
390145
0
0
360
1235
427067
1006201
108268
0
1659360220
390146
0
0
0
0
566000
901697
89209
0
1912905548
390147
0
0
0
0
549750
1006201
108339
0
1225417421
390150
0
0
0
0
591382
901697
87556
0
1972982882
390150
0
0
0
0
591382
901697
87556
0
1902804552
390151
0
0
0
0
640294
901697
60560
0
1215042114
390153
0
0
0
0
894406
1101073
145534
0
1730173550
390156
159051
111309
1547
0
352862
1101073
123696
0
1861486698
390156
159051
111309
1547
0
352862
1101073
123696
0
1962401497
390160
0
0
0
0
539000
1006201
102972
0
1073047981
390162
75610
51350
0
0
625314
1027228
89847
0
1457408973
390163
0
0
374
0
591000
916208
79892
0
1568577724
390163
0
0
374
0
591000
916208
79892
0
1144384082
390164
429609
170349
862
7967
363586
1006201
40072
306883
1821007881
390164
429609
170349
862
7967
363586
1006201
40072
306883
1447317896
390168
0
0
732
0
515034
1006201
19940
110540
1356334510
390173
0
0
0
0
537053
963421
27350
89275
1134297393
390174
52652
34199
731
45941
383273
1101073
16944
220716
1215916002
390174
463742
229874
1399
15681
377172
1101073
26424
306598
1225048838
390178
28914
1845
826
0
674040
925830
87205
0
1952465890
390178
28914
1845
826
0
674040
925830
87205
0
1356333579
390179
0
0
260
41582
430116
1101073
65199
95800
1457715146
390180
112319
70954
923
9057
384000
1101073
118368
0
1437182847
390183
0
0
0
0
569778
901697
91164
0
1144215039
390184
0
0
0
0
815338
1006201
64145
0
1548322720
390185
18769
18809
0
15960
461393
905284
79458
0
1518256726
390192
0
0
0
0
635752
905284
76182
0
1356354567
390194
0
0
0
0
565986
1010962
104157
0
1245335629
390195
146350
43945
0
21370
404312
1101073
90384
0
1548263973
390198
157011
55037
1444
0
386206
928272
52068
0
1265449870
390199
0
0
840
0
649447
901697
79965
0
1568459436
390201
0
0
0
0
473822
1255221
91164
0
1225091697
390203
0
0
0
2762
460513
1101073
170222
0
1124023015
390204
0
0
0
6730
410795
1101073
145926
0
1790219616
390211
0
0
359
42894
516785
925830
94316
0
1144255159
390217
0
0
803
0
613350
1006201
79517
0
1821015462
390219
51991
28021
360
3160
445265
1006201
81475
0
1407856099
390222
0
0
0
0
402183
1101073
80376
0
1245207521
390223
232106
71719
1750
19353
450145
1101073
197151
0
1083615587
390225
0
0
0
0
676859
955907
92128
0
1548423684
390225
0
0
0
0
676859
955907
92128
0
1063489342
390226
0
79589
0
4412
431688
1101073
8698
304908
1073587119
390228
0
0
0
0
490321
1006201
106589
0
1811992084
390231
129440
54408
0
21332
366297
1101073
130804
0
1730158981
390233
0
0
0
0
731036
931416
82947
0
1881983039
390237
15748
15537
0
1102
537339
905284
91530
0
1568435477
390256
543218
185283
516
1423
868053
976238
83382
0
1780686931
390258
0
0
0
0
941264
1101073
67360
139410
1578560504
390265
0
0
0
0
506455
1006201
102972
0
1023000296
390266
0
0
0
0
889640
925830
93609
0
1679592380
390267
51991
29760
0
0
527563
1006201
102972
0
1104991801
390268
0
0
0
4552
868457
995854
95991
0
1730173154
390268
0
0
0
4552
868457
995854
95991
0
1780750620
390268
0
0
0
4552
868457
995854
95991
0
1093001653
390270
0
0
0
0
415541
905284
29037
128579
1104292960
390270
0
0
0
0
415541
905284
29037
128579
1174822068
390270
0
0
0
0
415541
905284
29037
128579
1205197894
390270
0
0
0
0
415541
905284
29037
128579
1235424672
390270
0
0
0
0
415541
905284
29037
128579
1265728810
390270
0
0
0
0
415541
905284
29037
128579
1275620585
390270
0
0
0
0
415541
905284
29037
128579
1447538640
390270
0
0
0
0
415541
905284
29037
128579
1649305129
390270
0
0
0
0
415541
905284
29037
128579
1649568403
390270
0
0
0
0
415541
905284
29037
128579
1669768214
390270
0
0
0
0
415541
905284
29037
128579
1760777106
390270
0
0
0
0
415541
905284
29037
128579
1770953994
390270
0
0
0
0
415541
905284
29037
128579
1861791865
390270
0
0
0
0
415541
905284
29037
128579
1881980803
390270
0
0
0
0
415541
905284
29037
128579
1528026671
390272
0
0
500
0
0
1101073
41290
0
1467510560
390278
0
0
9140
0
0
1101073
155544
0
1083986129
390304
0
0
294
52838
496395
1101073
186550
0
1659392595
390307
0
0
0
0
403000
925830
93609
0
1780919043
390307
0
0
0
0
403000
925830
93609
0
1225678881
390314
0
0
0
0
300000
1010962
101977
0
1124193511
390316
0
0
0
0
300000
942514
95272
0
1033759626
390321
0
0
0
0
284000
1027228
102007
0
1336378132
390322
0
0
0
0
284000
1101073
112139
0
1528398534
390323
0
0
0
0
278000
1006201
102969
0
1265664544
390324
0
0
0
0
271000
1101073
112139
0
1578881652
390325
0
0
0
0
271000
931416
94163
0
1962758375
390325
0
0
0
0
271000
931416
94163
0
1497050470
390326
0
0
0
0
271000
1027228
102007
0
1760787576
390327
0
0
0
0
407000
931416
94163
0
1225323983
390328
0
0
0
0
268000
1006201
102972
0
1104192590
390329
0
0
0
0
268000
1101073
112139
0
1396194197
390330
0
0
0
0
389000
905284
91530
0
1881899284
390331
0
0
0
0
234000
1101073
112139
0
1265096069
390332
0
0
0
0
344000
901697
93208
0
1215598156
390333
0
0
0
0
326000
1006201
102972
0
1285295899
390333
0
0
0
0
326000
1006201
102972
0
1578124418
390333
0
0
0
0
326000
1006201
102972
0
1699235374
390333
0
0
0
0
326000
1006201
102972
0
1588269898
390334
0
0
0
0
327000
1006201
102972
0
1699340927
390335
0
0
0
0
326000
1027228
102007
0
1164029658
390336
0
0
0
0
326000
976238
83382
0
1609541853
390337
0
0
0
0
326000
901697
93208
0
1396402053
390338
0
0
0
0
327000
905284
91530
0
1013674266
390339
0
0
0
0
327000
955907
95692
0
999993
999993
75972
37367
433
8021
431343
976238
98592
0