An Official Pennsylvania Government Website
Translate
Begin Main Content Area

​

 Content Editor

2023 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 1058724 118270 0
1184620486 390130 0 0 0 0 672000 868883 60614 0
1164400131 390133 96119 30636 0 2145 517000 987719 89976 0
1255585303 390137 23063 14230 635 0 455845 870465 85364 0
1821091059 390138 0 0 0 0 791148 867016 62596 0
1508971441 390139 70978 34408 0 4335 408291 1058724 102866 0
1902805245 390142 369904 212140 1506 4035 365688 1058724 250510 0
1689691214 390145 0 0 360 1235 427067 967501 104104 0
1659360220 390146 0 0 0 0 566000 867016 85778 0
1912905548 390147 0 0 0 0 549750 967501 104172 0
1225417421 390150 0 0 0 0 591382 867016 84188 0
1972982882 390150 0 0 0 0 591382 867016 84188 0
1902804552 390151 0 0 0 0 640294 867016 58231 0
1215042114 390153 0 0 0 0 894406 1058724 139937 0
1730173550 390156 159051 111309 1547 0 352862 1058724 118938 0
1861486698 390156 159051 111309 1547 0 352862 1058724 118938 0
1073598439 390157 0 0 0 35511 621777 967501 99012 0
1962401497 390160 0 0 0 0 539000 967501 99012 0
1073047981 390162 75610 51350 0 0 625314 987719 86391 0
1457408973 390163 0 0 374 0 591000 880969 76819 0
1568577724 390163 0 0 374 0 591000 880969 76819 0
1144384082 390164 429609 170349 862 7967 363586 967501 38531 295080
1821007881 390164 429609 170349 862 7967 363586 967501 38531 295080
1447317896 390168 0 0 732 0 515034 967501 19173 106288
1356334510 390173 0 0 0 0 537053 926366 26298 85841
1134297393 390174 52652 34199 731 45941 383273 1058724 16292 212227
1215916002 390174 463742 229874 1399 15681 377172 1058724 25408 294806
1225048838 390178 28914 1845 826 0 674040 890221 83851 0
1952465890 390178 28914 1845 826 0 674040 890221 83851 0
1356333579 390179 0 0 260 41582 430116 1058724 62691 92115
1457715146 390180 112319 70954 923 9057 384000 1058724 113815 0
1437182847 390183 0 0 0 0 569778 867016 87658 0
1144215039 390184 0 0 0 0 815338 967501 61678 0
1548322720 390185 18769 18809 0 15960 461393 870465 76402 0
1518256726 390192 0 0 0 0 635752 870465 73252 0
1356354567 390194 0 0 0 0 565986 972079 100151 0
1245335629 390195 146350 43945 0 21370 404312 1058724 86908 0
1548263973 390198 157011 55037 1444 0 386206 892569 50065 0
1265449870 390199 0 0 840 0 649447 867016 76889 0
1568459436 390201 0 0 0 0 473822 1206943 87658 0
1225091697 390203 0 0 0 2762 460513 1058724 163675 0
1124023015 390204 0 0 0 6730 410795 1058724 140313 0
1184672214 390211 0 0 359 42894 516785 890221 90688 0
1144255159 390217 0 0 803 0 613350 967501 76459 0
1821015462 390219 51991 28021 360 3160 445265 967501 78341 0
1407856099 390222 0 0 0 0 402183 1058724 77285 0
1245207521 390223 232106 71719 1750 19353 450145 1058724 189568 0
1083615587 390225 0 0 0 0 676859 919141 88585 0
1548423684 390225 0 0 0 0 676859 919141 88585 0
1063489342 390226 0 79589 0 4412 431688 1058724 8363 293181
1073587119 390228 0 0 0 0 490321 967501 102489 0
1811992084 390231 129440 54408 0 21332 366297 1058724 125773 0
1730158981 390233 0 0 0 0 731036 895592 79757 0
1881983039 390237 15748 15537 0 1102 537339 870465 88010 0
1568435477 390256 543218 185283 516 1423 868053 938690 80175 0
1780686931 390258 0 0 0 0 941264 1058724 64769 134048
1578560504 390265 0 0 0 0 506455 967501 99012 0
1023000296 390266 0 0 0 0 889640 890221 90009 0
1679592380 390267 51991 29760 0 0 527563 967501 99012 0
1104991801 390268 0 0 0 4552 868457 957552 92299 0
1730173154 390268 0 0 0 4552 868457 957552 92299 0
1780750620 390268 0 0 0 4552 868457 957552 92299 0
1093001653 390270 0 0 0 0 415541 870465 27920 123634
1104292960 390270 0 0 0 0 415541 870465 27920 123634
1174822068 390270 0 0 0 0 415541 870465 27920 123634
1205197894 390270 0 0 0 0 415541 870465 27920 123634
1235424672 390270 0 0 0 0 415541 870465 27920 123634
1265728810 390270 0 0 0 0 415541 870465 27920 123634
1275620585 390270 0 0 0 0 415541 870465 27920 123634
1447538640 390270 0 0 0 0 415541 870465 27920 123634
1649305129 390270 0 0 0 0 415541 870465 27920 123634
1649568403 390270 0 0 0 0 415541 870465 27920 123634
1669768214 390270 0 0 0 0 415541 870465 27920 123634
1760777106 390270 0 0 0 0 415541 870465 27920 123634
1770953994 390270 0 0 0 0 415541 870465 27920 123634
1861791865 390270 0 0 0 0 415541 870465 27920 123634
1881980803 390270 0 0 0 0 415541 870465 27920 123634
1528026671 390272 0 0 500 0 0 1058724 39702 0
1467510560 390278 0 0 9140 0 0 1058724 149562 0
1083986129 390304 0 0 294 52838 496395 1058724 179375 0
1659392595 390307 0 0 0 0 403000 890221 90009 0
1780919043 390307 0 0 0 0 403000 890221 90009 0
1225678881 390314 0 0 0 0 300000 972079 98055 0
1124193511 390316 0 0 0 0 300000 906263 91608 0
1033759626 390321 0 0 0 0 284000 987719 98084 0
1336378132 390322 0 0 0 0 284000 1058724 107826 0
1528398534 390323 0 0 0 0 278000 967501 99009 0
1265664544 390324 0 0 0 0 271000 1058724 107826 0
1578881652 390325 0 0 0 0 271000 895592 90541 0
1962758375 390325 0 0 0 0 271000 895592 90541 0
1497050470 390326 0 0 0 0 271000 987719 98084 0
1760787576 390327 0 0 0 0 407000 895592 90541 0
1225323983 390328 0 0 0 0 268000 967501 99012 0
1104192590 390329 0 0 0 0 268000 1058724 107826 0
1396194197 390330 0 0 0 0 389000 870465 88010 0
1881899284 390331 0 0 0 0 234000 1058724 107826 0
1265096069 390332 0 0 0 0 344000 867016 89623 0
1215598156 390333 0 0 0 0 326000 967501 99012 0
1285295899 390333 0 0 0 0 326000 967501 99012 0
1578124418 390333 0 0 0 0 326000 967501 99012 0
1699235374 390333 0 0 0 0 326000 967501 99012 0
1588269898 390334 0 0 0 0 327000 967501 99012 0
1699340927 390335 0 0 0 0 326000 987719 98084 0
1164029658 390336 0 0 0 0 326000 938690 80175 0
1609541853 390337 0 0 0 0 326000 867016 89623 0
1396402053 390338 0 0 0 0 327000 870465 88010 0
1013674266 390339 0 0 0 0 327000 919141 92012 0
999993 999993 75972 37367 433 8021 431343 938690 94800 0