New Report on California Workers’ Comp Medical Payment Trends

October 3, 2022

The Workers’ Compensation Insurance Rating Bureau of California released an updated California Workers’ Compensation Aggregate Medical Payment Trends report for 2021.

The latest annual report compares medical payment information from 2019 through 2021. It analyzes medical payment and utilization trends by provider type, service locations and different service types.

Findings from the report include:

  • Overall medical payments per claim rose significantly, driven by increases in the payments per transaction. The increase in payments per transaction was largely due to the 2021 fee schedule updates to medical-legal and evaluation and management services.
  • The 2021 Medical-Legal Fee Schedule and 2021 updates to the reimbursement allowance for evaluation and management services drove up average payments per service as well as medical payment share for medical-legal services and evaluation and management services in 2021.
  • Office or other outpatient service procedures continued to grow and are the fastest-growing physician service in 2021. Use of analgesics anti-inflammatory prescriptions increased more significantly than that of any other therapeutic group.

The report also found that telehealth service use continued to decline in 2021. However, it still remained at a far higher level than pre-pandemic periods.