The New CMS

7 Reasons to participate in the Workers’ Compensation System

Colorado’s workers’ compensation system is considered a model for other states because of its comprehensive and frequently updated guidelines, accessibility and fee structure that pays more than Medicare and private insurers. Yet despite many benefits, a recent survey among CMS members revealed a number of misperceptions by providers who don’t participate in the system. Here are seven reasons to participate in the Colorado workers’ compensation system.

  1. The system is continually improving.
    The CMS Workers’ Compensation and Personal Injury Committee (WCPIC) advocates for Colorado physicians who care for injured workers. It is the mission of the WCPIC to reduce administrative hassles associated with the workers’ compensation system and to work with the Division of Workers’ Compensation (DOWC) to seek improvements in education, public outreach, research, legislation, and patient treatment. WCPIC has been actively involved in these enhancements.
  2. Increased value of participation.
    Special codes with additional fees exist for completion of required paperwork. The DOWC fee schedule reimburses at a level higher than most health insurance carriers in Colorado. Overall, physicians are compensated fairly for care of the injured workers.
  3. Get support for patient education and shared decision-making.
    Additional fees through increased E&M coding are available for physicians who spend time with patient counseling and monitoring. DOWC recognizes the complexity of work and reimburses accordingly.
  4. Bill for documenting a patient’s functional progress.
    The new Quality Performance and Outcomes Payments section of Rule 18 - Medical Fee Schedule allows certified providers* to bill for documenting a patient’s functional progress, which includes providing a functional assessment and psychological screen.

    *Certification requirements include attendance at or accreditation in Level I or II, attendance of a QPOP session, a passing score on the QPOP examination, and submission of a sufficient report.
  5. Workers’ comp expands your practice.
    Workers will bring themselves and their families back to your practice for their personal health care needs. Often you will find non-work related issues that patients need to have addressed; i.e. hypertension, smoking cessation, thyroid disease, routine health screening, mammography and colonoscopy.
  6. Colorado Workers’ Compensation emphasizes the protection of workers in the work environment.
    DOWC continues to develop innovative programs to decrease worker injuries.
  7. Neither Level I or Level II accreditation is required.
    Level II accreditation is not required to treat patients in the Colorado Workers’ Compensation system. The system works just as well when a physician forms a good relationship with those who specialize in treating injured workers such as an occupational medicine group, PMR group or pain management group. This works particularly well in a rural area where the local physician manages the clinical issues and gets the specialist’s input to guide the workers’ comp case and perform the impairment rating.

View/download this information as a PDF.


FOR MORE INFORMATION: Stay tuned this page and other CMS communications to learn more about these important changes, follow our progress and learn how you can get involved. We want to hear from you and are available to answer your questions. Please contact CMS President Katie Lozano, MD, FACR, at president@cms.org.