Medical Fees & Hospital Rates

The Director of the Department of Labor and Training establishes a medical fee schedule of rules and rates of reimbursement for workers' compensation medical services.

Hospital services are subject to the Hospital Rates instead of the medical fee schedule.

The amount a hospital is paid for services for a workers' compensation injury is adjusted. Annually, the Division of Workers' Compensation publishes an adjustment rate for hospital charges for each hospital's charges for inpatient, ambulatory surgery, and emergency room charges. The adjustments are based on approved cost finding methodology and other statistical data furnished by each hospital.

A hospital's charges should be multiplied by the corresponding percentage based on date of service, hospital, and if the type of service is inpatient, ambulatory surgery, or emergency room. below.

For example: Newport Hospital provided an inpatient service on July 5, 2012. Based on the chart that covers services from July 1, 2012 to June 30, 2013, the inpatient adjustment for an inpatient service at Newport Hospital is 74.76%. The total charge for the service is $1000. Multiply the charge for service by the adjustment: $1000 times 74.76% = $747.60, which is the amount Newport Hospital would be paid for that service. 

Click on the dates below for the information letter containing the Hospital Rate Adjustments

View or order a copy (printed or electronic) of the RI Medical Fee schedule online at Rising Medical Solutions, Inc. ®

The Medical Advisory Board (MAB) adopts and reviews protocols of treatment for work-related injuries and provides notice of impartial medical exams required at 26 and 39 weeks of incapacity. The MAB also records complaints against and is authorized to disqualify medical care providers. You can reach the Medical Advisory Board at One Dorrance Plaza Providence, RI 02903. Phone: (401) 458-3460 | Email: John F. McBurney, Administrator

For more information abut the medical fee schedules, please contact:

Matt Carey

 (401) 462-8127