The National Council on Compensation Insurance (NCCI) published a new research brief on medical fee schedules and workers’ compensation in 2025, which reports on changes to CMS reimbursement rules that may impact medical costs in workers’ comp.

The overall impact that recent CMS updates have on medical costs in workers’ comp varies by state, depending on how each fee schedule incorporates CMS rules and rates.

The report found that physician costs account for approximately 40% of national workers’ comp medical expenditures, while facility costs accounted for another 40%. Costs for DME, prosthetics, orthotics, and supplies varied by state, ranging from 4-14% of costs.

Additional highlights from the report include:

• The physician conversion factor was updated to 32.3465, a 2.8% decrease from the 2024 conversion factor of 33.2875
• Facility base rates saw moderate increases that were in line with the increases seen in prior years
• Changes to the rural floor and low wage hospital policy in the wage index calculation have impacted wage indices in recent years
• The 2.4% increase to the CMS DMEPOS update factor in 2025 is in line with the increase from last year