On May 1, 2019, the New York State Workers’ Compensation Board (“WCB”)
adopted amendments to Subpart 329-3 of 12 NYCRR, updating and establishing
fees for emergency room (“ER”) services, rural area outpatient
clinics, hospital-based mental health clinics, and private psychiatric
hospitals. The amendments increase ER reimbursement rates that were last
updated in 1995, and for the first time establish fees for both rural
clinics and private psychiatric hospitals.
Beginning July 15, 2019, the new fee schedule rate for emergency room services
will be one hundred fifty (150%) percent of the Department of Health’s
Enhanced Ambulatory Patient Groups (“EAPG”) Base Rate Fees,
which means that rates will fluctuate based on the quantity and type of
The New York State Department of Financial Services (“DFS”) has
not passed an emergency regulation delaying the application of this new fee
schedule rate to No-Fault (i.e. to treatment rendered to automobile accident
victims). As such, these updated and newly established rates will affect
all treatment rendered to No-Fault patients on or after July 15, 2019.
The Firm encourages its clients to speak directly with their billing and
coding professionals to obtain a more in depth understanding of the services
which will be impacted by these amendments.
The full text of the amendment can be found on the WCB’s website
via the following link:
http://www.wcb.ny.gov/content/main/wclaws/Subpart_329_3ERandClinic/Subpart_329_3ERandClinic.jsp. The amendment’s effective date can be found on the WCB’s
website via the following link: