Purpose


The proposed rule incorporates the 2016 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals (Manual), as approved by the Three-Member Panel during a scheduled meeting held on April 20, 2016, pursuant to paragraph 440.13(12)(a), F.S. The 2016 Edition of the Manual increases the per diem reimbursement rates for surgical and non-surgical hospital inpatient services and the threshold dollar amount triggering Stop-Loss reimbursement above reimbursement allowances specified in the 2014 Edition of the Manual, as adopted by the existing rule. The 2016 Edition of the Manual also provides an updated fee schedule for various categories of hospital outpatient services based on the Current Procedural Terminology (CPT) line level charge data, with an adjustment of the Maximum Reimbursement Allowance (MRA) based on the geographic location of the service provider.