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The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) has released California Workers’ Compensation Aggregate Medical Payment Trends – Updated through Calendar Year 2021.This report compares medical payment information from 2019 through 2021. The annual report analyzes medical payment and utilization trends by provider type, service locations and different service types.

Key findings from the report include:

General Trends in the Medical Payments and Transactions in 2021

– – Overall medical payments per claim increased significantly, mostly driven by increases in payments per transaction.
– – The increase in payments per transaction was largely because of the 2021 fee schedule updates to Medical-Legal and Evaluation and Management services.
– – Utilization of telehealth services continued to decline in 2021 but still remained at a much higher level than during pre-pandemic periods.

Fastest Growing Physician Services Procedures and Therapeutic Group

– – Office or other outpatient service procedures continued to grow and are the fastest growing physician service in 2021.
– – Use of Analgesics Anti-Inflammatory increased more significantly than that of any other therapeutic group.

Impacts of Fee Schedule Updates to Medical-Legal and Evaluation and Management Services

– – The 2021 Medical-Legal Fee Schedule drove up average payments per Medical-Legal service as well as medical payment share for Medical-Legal services in 2021 compared to the prior two years.
– – Similarly, the 2021 update to the reimbursement allowance for Evaluation and Management services led to a large increase in the payments per transaction and payment share for Evaluation and Management services in 2021 compared to the prior two years

The report is available in the Research section of the WCIRB website.