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For services provided on or after October 1, 2015, Medicare requires that healthcare providers must use valid ICD-10 Codes. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services.  For additional details and assistance, please visit: : CPT Codes | American Medical Association (ama-assn.org)


Regulations and methodologies implemented/effective March 2008, March 2012 and Febuary 2020.  Values are effective for date of service by calendar year.
For an overview of 2008 changes, see this presentation in Adobe  Reader PDF

Medical Fee Guide (MFG) materials provided exclude procedure descriptors.

All questions regarding the MD WCC Medical Fee Schedule should be sent via email: [email protected] or via telephone
(410) 864-5320; outside Baltimore Metro area toll free (800) 492-0479 selecting extension 5320 when prompted, during normal business hours. 


  • Regulation Spotlight
  • Periodically, the Commission will spotlight a regulation or part of a regulation to showcase a change or merely to remind the community of what a regulation actually says (as opposed to what we think it says). 
  • ASC Implants:  To facilitate the processing of Claim for Medical Services (form C-51) in a more efficient manner, the ASC should document the exact implants and number of implants used with invoices for the implants. Implants used should be documented in the body of the operative report and noted in a separate paragraph at the end of the operative report.

The Regulation, Rates & Related Documents (All materials are Adobe  Reader PDF format unless otherwise noted.)

Maryland Specific Conversion Factor (MSCF) / Percentage Multiplier information

How to obtain or calculate reimbursement

 

The five character codes included in the Maryland Workers' Compensation Commission Guide of Medical and Surgical Fees are obtained from Current Procedural Terminology (CPT®), copyright 2023 by the American Medical Association (AMA). CPT® is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures.

The responsibility for the content of the Maryland Workers' Compensation Commission Guide of Medical and Surgical Fees is with the MD WCC and no endorsement of the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in the Maryland Workers' Compensation Commission Guide of Medical and Surgical Fees. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT®, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Any use of CPT® outside of the Maryland Workers' Compensation Commission Guide of Medical and Surgical Fees should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT® codes and descriptive terms.

CPT® is a registered trademark of the American Medical Association.