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2020 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)
1124405592 390001 36081 15591 646 36277 485198 738563 18955 143155
1255540647 390001 36081 15591 646 36277 485198 738563 18955 143155
1285032128 390001 36081 15591 646 36277 485198 738563 18955 143155
1326446253 390001 36081 15591 646 36277 485198 738563 18955 143155
1336526276 390001 36081 15591 646 36277 485198 738563 18955 143155
1366444507 390001 36081 15591 646 36277 485198 738563 18955 143155
1417334350 390001 36081 15591 646 36277 485198 738563 18955 143155
1467850149 390001 36081 15591 646 36277 485198 738563 18955 143155
1497132336 390001 36081 15591 646 36277 485198 738563 18955 143155
1548648272 390001 36081 15591 646 36277 485198 738563 18955 143155
1770960130 390001 36081 15591 646 36277 485198 738563 18955 143155
1972652063 390001 36081 15591 646 36277 485198 738563 18955 143155
1194734798 390002 135468 52932 414 0 551833 820895 77596 0
1942364898 390002 135468 52932 414 0 551833 820895 77596 0
1821198755 390003 0 0 297 0 579483 738563 72145 0
1841408739 390003 0 0 297 0 579483 738563 72145 0
1891852703 390003 0 0 297 0 579483 738563 72145 0
1881690212 390004 0 0 0 1397 498517 796449 63475 0
1013384809 390006 263657 107593 444 15014 508391 738563 64051 0
1033491741 390006 263657 107593 444 15014 508391 738563 64051 0
1063540011 390006 263657 107593 444 15014 508391 738563 64051 0
1063708501 390006 263657 107593 444 15014 508391 738563 64051 0
1154617694 390006 263657 107593 444 15014 508391 738563 64051 0
1235215427 390006 263657 107593 444 15014 508391 738563 64051 0
1245632231 390006 263657 107593 444 15014 508391 738563 64051 0
1275832164 390006 263657 107593 444 15014 508391 738563 64051 0
1275850620 390006 263657 107593 444 15014 508391 738563 64051 0
1417231937 390006 263657 107593 444 15014 508391 738563 64051 0
1427344969 390006 263657 107593 444 15014 508391 738563 64051 0
1457650343 390006 263657 107593 444 15014 508391 738563 64051 0
1467748475 390006 263657 107593 444 15014 508391 738563 64051 0
1528197720 390006 263657 107593 444 15014 508391 738563 64051 0
1659762862 390006 263657 107593 444 15014 508391 738563 64051 0
1669768289 390006 263657 107593 444 15014 508391 738563 64051 0
1770879215 390006 263657 107593 444 15014 508391 738563 64051 0
1851508162 390006 263657 107593 444 15014 508391 738563 64051 0
1982037966 390006 263657 107593 444 15014 508391 738563 64051 0
1982988408 390006 263657 107593 444 15014 508391 738563 64051 0
1710087069 390008 0 0 0 0 642456 820895 64050 0
1861435042 390009 35262 16381 283 16884 388855 757317 80485 0
1386896306 390012 0 0 0 0 681384 898294 79966 0
1124076039 390013 0 0 0 0 770580 735637 49885 0
1477538312 390016 0 0 383 46405 645555 820895 84009 0
1356313464 390026 102863 44440 0 0 700974 898294 63855 0
1962579029 390027 369197 164426 3735 1000 346350 898294 42622 192996
1568526135 390028 212670 105091 638 19969 407418 820895 89095 0
1881695146 390028 212670 105091 638 19969 407418 820895 89095 0
1235138405 390030 0 0 0 36715 651378 735637 74375 0
1689679581 390032 0 0 0 6702 511963 820895 84009 0
1669405072 390035 0 0 0 0 361107 898294 91487 0
1063422053 390036 39427 27555 0 969 537674 820895 38651 69880
1588770416 390037 0 0 0 43300 635158 820895 86340 0
1912900168 390039 0 0 825 2588 541040 749078 79940 0
1871594127 390041 0 0 841 23769 496716 820895 84009 0
1609984889 390042 43209 30912 256 42196 0 820895 84009 0
1669530069 390044 84971 23313 0 21042 468000 768937 66815 0
1609801976 390045 44467 21869 287 5640 402000 726115 14893 118171
1326060492 390046 144496 64117 259 5922 604415 759882 59808 0
1609263946 390048 8240 34578 0 0 770000 735637 72712 0
1639560550 390048 8240 34578 0 0 770000 735637 72712 0
1689061921 390048 8240 34578 0 0 770000 735637 72712 0
1750778981 390048 8240 34578 0 0 770000 735637 72712 0
1861545683 390048 8240 34578 0 0 770000 735637 72712 0
1013933175 390049 68656 32236 0 133798 607630 838049 83222 0
1548293954 390049 68656 32236 0 133798 607630 838049 83222 0
1285667493 390050 248542 77734 534 3112 387091 820895 42263 105269
1427022078 390052 0 0 0 4853 513732 735637 55994 0
1700878840 390056 0 0 0 0 597279 735637 10652 168020
1568459287 390057 0 0 0 0 450593 898294 98775 0
1689107328 390058 0 0 0 3047 554630 796449 66408 0
1083147656 390061 0 0 286 18710 628825 779862 82843 0
1497708473 390062 0 0 0 0 734000 771563 76351 0
1487647590 390063 52946 32583 539 6973 397020 757317 76563 0
1265466957 390065 0 0 0 0 736431 896334 91303 0
1407928500 390066 39353 17255 0 0 492272 796449 61983 0
1407813603 390067 130828 52674 433 2232 445000 796449 70904 0
1285167916 390068 58594 33076 854 0 193955 779862 79711 0
1528319621 390070 9153 2964 0 0 431480 898294 52605 0
1841712882 390071 0 0 0 0 686000 735637 73216 0
1316919699 390072 0 0 710 0 519617 738563 68351 0
1649278730 390073 37941 30974 410 25331 446000 771563 77988 0
1083685622 390076 0 0 411 33214 487369 898294 36094 137219
1083614382 390079 112108 37346 0 20184 634945 735637 24788 149495
1912902206 390080 7099 5644 0 0 387978 898294 26936 155798
1548624851 390081 29962 0 0 0 351953 898294 64831 0
1710409750 390084 0 0 0 0 554025 735637 51362 0
1144249657 390086 0 0 400 0 677485 735637 72718 0
1194744805 390090 174532 60762 649 37073 356554 820895 84009 0
1619069440 390091 0 0 0 3356 597181 735637 78114 0
1265422901 390093 30411 20351 0 0 620784 735637 5540 107822
1699734665 390096 26367 33298 859 3219 528137 768937 26285 72806
1750371522 390097 0 0 0 570 357027 898294 81053 0
1104875103 390100 56910 18259 0 19607 724335 779862 57326 0
1063945707 390101 92128 52381 390 0 497259 759882 54370 0
1750445607 390102 110841 116437 0 14691 462514 820895 89624 0
1790795359 390102 110841 116437 0 14691 462514 820895 89624 0
1861478307 390104 0 0 0 0 0 810462 74375 0
1225047699 390107 0 0 0 0 560569 820895 66436 0
1639218936 390107 0 0 0 0 560569 820895 66436 0
1801897038 390110 126380 68584 690 37359 416925 737220 25124 100610
1851370910 390111 539305 313211 1585 7937 321731 898294 23759 307469
1275620536 390112 0 0 0 0 607604 737220 7701 88736
1942276423 390113 0 0 1000 0 802026 752094 66750 0
1659435501 390114 147995 110633 1702 0 479453 820895 34826 141154
1952311508 390114 147995 110633 1702 0 479453 820895 34826 141154
1114095791 390115 60642 41217 671 31461 288789 898294 50289 87952
1205904885 390115 60642 41217 671 31461 288789 898294 50289 87952
1215952106 390115 60642 41217 671 31461 288789 898294 50289 87952
1801963343 390115 60642 41217 671 31461 288789 898294 50289 87952
1124495239 390116 219851 95443 268 894 449520 898294 96133 142103
1295724193 390117 0 0 0 0 726684 735637 59790 0
1578569885 390118 0 0 0 0 414013 735637 63794 0
1922376136 390119 24716 27385 0 0 428010 738563 6517 132645
1891768099 390123 0 0 0 0 475055 898294 79782 0
1124026182 390125 0 0 0 0 562680 735637 74375 0