Plan 2 Security Deposit Forms
Montana Historic WC Medical Reimbursement Conversion Factors
(As of Jan 1, 2004)
| Provider Type | 1995 | 1996 | 1997 | 1998 | 1999 | 2000 | 2001 | 2002 |
2003
|
2004 |
| Acupuncture | 4.03 | 4.11 | 4.15 | 4.27 | 4.43 | 4.58 | 4.73 | 4.89 |
5.09
|
5.24 |
| Anesthesia | 30.96 | 31.54 | 31.87 | 32.86 | 34.10 | 35.26 | 36.42 | 37.66 |
39.23
|
40.43 |
| Chiropractic | 4.03 | 4.11 | 4.15 | 4.27 | 4.43 | 4.58 | 4.73 | 4.25 |
4.85
|
4.93 |
| Dental | 7.77 | 7.92 | 8.00 | 8.25 | 8.56 | 8.85 | 9.14 | 9.45 |
9.85
|
10.15 |
| Medical Doctors | 4.03 | 4.11 | 4.15 | 4.27 | 4.43 | 4.58 | 4.73 | 4.89 |
5.09
|
5.24 |
| Occupational Therapy | 6.28 | 6.40 | 6.46 | 6.66 | 6.91 | 7.14 | 7.37 | 4.25 |
4.85
|
4.93 |
| Pathology | 14.43 | 14.70 | 14.85 | 15.31 | 15.89 | 16.43 | 16.97 | 17.55 |
18.28
|
18.84 |
| Physical Therapy | 6.28 | 6.40 | 6.46 | 6.66 | 6.91 | 7.14 | 7.37 | 4.25 |
4.85
|
4.93 |
| Radiology | 16.65 | 16.97 | 17.14 | 17.67 | 18.33 | 18.95 | 19.57 | 20.23 |
21.07
|
21.71 |
| Surgery | 86.09 | 87.71 | 88.63 | 91.39 | 94.85 | 98.08 | 101.31 | 104.77 |
109.15
|
112.49 |
| CPT Code 97750 |
NA
|
NA
|
NA
|
NA
|
NA
|
NA
|
NA
|
26.50
|
27.60
|
28.44 |
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