On October 28th, Healthesystems attended South Dakota’s final Workers’ Compensation Advisory Council meeting of 2025 to capture key updates.

The Department of Labor and Regulation confirmed the adoption of amendments to the Medical Fee Schedule rules, incorporating the 2025 Relative Values for Physicians. The updated rules were filed with the Secretary of State at the end of October and take effect 20 days after filing.

The Council also reviewed NCCI’s September 2025 Medical Data Report comparing South Dakota’s medical costs to national trends.

In 2024, 14.8% of South Dakota claims had prescription drugs, compared to 26.8% nationwide. However, median payments for brand drugs were slightly higher in South Dakota at $478, compared to $477 nationwide. As for generics, South Dakota median payments were $30, compared to $38 nationwide.

Physical medicine made up 30.4% of payments in South Dakota, compared to 38.5% nationwide in 2024. Patients had faster access to physical medicine at 15 days in South Dakota, compared to 27 days nationwide.

Radiology made up 11.7% of South Dakota medical payments, higher than the 8.5% national average. However, time to treatment was 1 day in South Dakota, versus 2 days nationwide.

Across DMEPOS, South Dakota reported a 58.7% share of spend on supplies other than DME, significantly higher than the 38.7% national average. However, South Dakota only saw 12.6% of payment shares go to DME, while the national average was 29.1%. Additionally, home health and transportation payments were below national averages in South Dakota.

The report also listed a breakdown of top procedure codes by payment for physical medicine, radiology, and prescription drugs. No questions were raised regarding the report. Understanding medical cost trends provides valuable context to anticipate policy shifts and identify emerging cost drivers.