DWC Announces Annual Change to Medical Fee Guideline Conversion Factors

The Medical Fee Guideline conversion factors are established by 28 Texas Administrative Code §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.

DWC established a conversion factor and an annual update to provide predictability and reflect changes in medical service delivery costs to system participants. 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 2023 reflects an increase of 3.8 percent. This will be applied to services provided on or after January 1, 2023.

For services provided in calendar year 2023, the new Medical Fee Guideline conversion factors are $64.83 and $81.38. The conversion factor of $64.83 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 $81.38 applies to surgery when performed in a facility setting.

System participants are encouraged to contact DWC with any questions by calling (800) 252-7031 option 3, or by emailing CompConnection@tdi.texas.gov.

Updated conversion factors can also be found on the TDI website:
https://www.tdi.texas.gov/wc/fee/conversionfactors.html.