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Medical Services Provider Manual

Any appropriately-licensed medical provider who is authorized by the employer or insurance carrier may treat workers' compensation claimants. The  Medical Services Provider Manual (MSPM) outlines billing and payment policy for physicians and other health care professionals and provides the current schedule of fees. The fee schedule does not cover hospital charges, general dental, EMS Services, Emergency Air Transportation, or services rendered outside of South Carolina.

At the August 15, 2016 business meeting, the Commission approved a revision to the MSPM to reflect 2016 Resource Based Relative Values (RBRVS) issued by the Center for Medicare/Medicaid (CMS) and the American Medical Association's current Procedural Terminology (CPT) Codes. Included in the approval is a Conversion Factor of $50 and no change to the Maximum Allowable Payments (MAP) for an Independent Medical Examination (IME). The IME fee will remain rated as Individual Consideration. The effective date is September 1, 2016.  

Click the following link for information on how to purchase the 2016 Medical Services Provider Manual. It is imperative that providers and carriers obtain the 2016 MSPM to assure compliance.

2016 Medical Services Provider Manual

 

 2010 Medical Services Provider Manual

Effective March 21, 2017, the 2010 Medical Services Provider Manual is available in CD version only. Use the following link to order the 2010 Medical Services Provider Manual online and submit payment via credit card:  2010 Medial Services Provider Manual - CD version 

Click the following link for a brochure and order form to submit payment via check: 
2010 Medical Service Provider Manual Brochure

Revision Notices - 2010 Medical Services Provider Manual

2010 Medical Services Provider Manual Pricing Corrections and Revisions Effective January 1, 2013

 2010 Medical Services Provider Manual, Section 2, Anesthesia

Pharmacy Fee Schedule Effective December 19, 2011 

 

Updated HCFA 1500 Form
Beginning January 1, 2014, health care providers were able to submit medical payment requests using the revised 1500 form. After March 31, 2014, healthcare providers will no longer be allowed to submit payment requests under the previous versions of the 1500 form. Read more...