The 2017, 2018 and 2019 locality-specific anesthesia conversion factors (CFs) are calculated from the 2017 national anesthesia CF.
The purpose of this is to inform workers’ compensation system participants of the annual change to the Medical Fee Guideline conversion factors as established in 28 TAC §134.203. Under Labor Code §413.011(a), fee guidelines adopted by the Division of Workers’ Compensation (DWC) for non-network services and approved out-of-network services are based on the most current reimbursement methodologies, models, and values or weights used by the federal Centers for Medicare and Medicaid Services.
To provide predictability and reflect changes in medical service delivery costs to system participants, DWC established a conversion factor and an annual update as part of 28 TAC §134.203(c). The annual update is based on the Medicare Economic Index (MEI), which is a weighted average of price changes for goods and services used to deliver physician services. The MEI for 2019 reflects an increase of 1.4 percent.
For services provided in calendar year 2019, the new Medical Fee Guideline conversion factors are $58.31 and $73.19. The conversion factor of $58.31 applies to service categories of evaluation and management, general medicine, physical medicine and rehabilitation, radiology, pathology, anesthesia, and surgery when performed in an office setting. The conversion factor of $73.19 applies to surgery when performed in a facility setting.
As part of 28 TAC §134.203(c)(2), DWC adopted a provision that will automatically update the conversion factors each year based on the MEI. The MEI annual percentage adjustment is published each November in the Federal Register as a part of the Medicare Physician Fee Schedule update. DWC monitors the annual percentage adjustment change to the MEI, and posts the conversion factors for the subsequent year on its website in December.