In 2007, the Montana Legislature passed legislation that directed the Department of Labor and Industry to establish a schedule of fees for medical services that are necessary for the treatment of injured workers. Since 1991 the Department has maintained a system of hospital discount factors that limited the hospital rate increases to no more than the state's average weekly wage increase.

The Department has chosen to base the Workers’ Compensation Facility Fee Schedule (effective December 1, 2008) on the Medicare Severity Diagnosis Related Group (MS-DRG) payment methodology for facility inpatient reimbursement and the Ambulatory Payment Classification (APC) payment methodology for outpatient services. These payment systems have been selected because they are widely used nationally by programs such as Medicare, Medicaid, commercial health insurance payers and other state workers’ compensation systems. The adoption of a system that is widely used and understood by health care providers will allow Montana’s workers’ compensation payment rates to be easily benchmarked against other state workers’ compensation payment levels and with payment levels of other commercial and government payers.

This site contains the Montana Facility Fee Schedule. The schedule will apply to all services and procedures provided in a facility on or after December 1, 2008 covered under Chapter 71 of the Montana Workers’ Compensation Act. Workers’ compensation payers must use this schedule when paying charges submitted by medical facility providers, unless otherwise specified in the Act.

Click here to continue to the Montana Facility Fee Schedule

Resources

Unit One - Understanding Montana Worker's Compensation (WC) Facility Fee Schedule

Unit Two - Understanding the Workers' Compensation (WC) Facility Fee Schedule (Using the UB04)

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Administrative Rules of Montana

Facility Fee Schedule Administrative Rules of Montana