On August 4th, Healthesystems attended the South Dakota Workers’ Compensation Advisory Council meeting, where the Council approved the initiation of rulemaking to update physician reimbursement rates.

The vote authorizes the Department of Labor to begin the process of adopting the 2025 Optum Relative Values for Physicians (RVPs) for medical services and treatment, replacing the current 2020 version.

Optum’s RVP system establishes standardized procedure pricing, which is adjusted by the state’s conversion factors.

The Council received confirmation that the current conversion factor multipliers will remain unchanged.  The rulemaking will amend Rule 47:03:05:02, Incorporation of Relative Values for Physicians, though a timeline for the process was not disclosed.

This rulemaking will alter reimbursement logic, impacting how medical services are priced and adjudicated. Attending meetings such as these helps stakeholders to stay informed of these downstream impacts and remain prepared for necessary business adjustments.