In 2007, the Montana Legislature passed legislation that directed the Department of Labor and Industry to establish a RBRVS-based fee schedule for nonfacility medical services provided to injured workers.

The Montana workers’ compensation medical fee schedule has been in place since 1973. For much of its history, it has been based on the Relative Value for Physicians’ relative value unit (RVU) system. In recent years, many other states have transitioned their workers’ compensation fee schedules to the Resource Based Relative Value Scale (RBRVS) developed by the Centers for Medicare and Medicaid Services (CMS) based on national medical market data. Montana’s major medical insurance payers, Medicaid, Medicare, and Blue Cross/Blue Shield of Montana, all use the RBRVS-based reimbursement system.

Over the past five years, staff of the Medical Regulations Unit in the Department have been researching and soliciting input from stakeholders on the feasibility and benefit of converting Montana’s workers’ compensation fee schedule to the RBRVS-based system. A RBRVS-based reimbursement system would provide some consistency with the major medical insurance payers for efficiency and convenience of both providers and payers.

This site contains the Montana Nonfacility Fee Schedule. The schedule applies to all services and procedures provided on or after January 1, 2008 covered under Chapter 71 of the Montana Workers’ Compensation Act. Workers’ compensation payers shall use this schedule and the instruction set when paying charges submitted by medical providers, unless otherwise specified in the Act.

The fee schedule contains four pages:

1. Use and Copyrights
   This page explains the permitted uses of the data and the codes associated with the American Medical Association and the American Society of Anesthesiologists.
2. Fee Schedule
   This page allows users to search for and download ranges of codes or the entire fee schedule.
3. Instruction Set
   This page contains the instructions and guidelines associated with the fee schedule.
4. Data Specifications
   This page describes the computer format of the data.

If you have any questions about the fee schedule, please refer to the Frequently Asked Questions page or contact the Medical Regulation Unit by email at shapeterson@mt.gov or by telephone at (406) 444-7732.