Skip Ribbon Commands
Skip to main content
An Official Pennsylvania Government Website
Translate
Begin Main Content Area

​​​​

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​