Rule 69L-30.008, F.A.C., Billing and Reimbursement for Expert Medical Advisor Services

The Florida Department of Financial Services, Division of Workers' Compensation, announces a virtual meeting of the Three-Member Panel that will be held on Wednesday, October 8, 2025, at 11:00 a.m. Eastern Time.

GENERAL SUBJECT MATTER TO BE CONSIDERED:

The Division will present to the Panel a recommendation for the methodology for the Maximum Reimbursement Allowances (MRAs) for Hospital Outpatient Services and present the Annual Report on the resolution of health care provider medical reimbursement disputes pursuant to s.440.13(12)(j), Florida Statutes.

A copy of the agenda and the related meeting documentation may be found here.

PLACE: This meeting will not be held in person. Please join the meeting from your computer, tablet, or smartphone.
https://global.gotomeeting.com/join/626020717

You can also dial in using your phone. United States (Toll Free): 1(866)899-4679, United States: (571)317-3116, Access Code: 626-020-717
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Notice of this public meeting appeared in Volume 51, Number 190, of the Florida Administrative Register, published on September 30, 2025.

If you have questions about the contents of this notice, please contact Charlene Miller, Bureau Chief of the Bureau of Monitoring and Audit, Division of Workers' Compensation at Charlene.Miller@myfloridacfo.com.

On Wednesday, August 20th at the annual Workers’ Compensation Educational Conference hosted by WCI, the Division held its breakout session covering Legislative and Regulatory updates. Additionally, the Division panel discussed and outlined stakeholder responsibilities and impacts to claims. Below is a link to the presentation shown during this session.

• Panel Presentation

The Florida Department of Financial Services, Division of Workers' Compensation announces a virtual meeting of the Three-Member Panel that will be held Tuesday, January 14, 2025, at 1:00 p.m., Eastern Time.

GENERAL SUBJECT MATTER TO BE CONSIDERED:
Subparagraph 440.13(12)(j)4., F.S., requires the Three-Member Panel to submit recommendations on or before January 15, 2017, and biennially thereafter, to the President of the Senate and the Speaker of the House of Representatives on methods to improve the workers’ compensation health care delivery system. The Three-Member Panel will consider adopting recommendations at this meeting.

A copy of the agenda can be found here.
A copy of the Biennial Report – DRAFT can be found here.
The Report to the Three-Member-Panel Regarding the Resolution of Medical Reimbursement Disputes can be found here.

PLACE: Please join my meeting from your computer, tablet, or smartphone.
https://meet.goto.com/625443429

You can also dial in using your phone. United States (Toll Free): 1(866)899-4679,
United States: (571)317-3116, Access Code: 625-443-429

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Notice of this public meeting appeared in Volume 50, Number 252, of the Florida Administrative Register, published on December 30, 2024.

If you have questions about this communication, please contact Theresa Pugh, Program Administrator, Medical Services Section, Division of Workers' Compensation, Department of Financial Services, by phone at (850) 413-1721 or Theresa.Pugh@myfloridacfo.com.

The Florida Commerce's Bureau of Workforce Statistics and Economic Research has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $1,295.14 for the four calendar quarters ending June 30, 2024.

Section 440.12(2), Florida Statutes (2024), expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Bureau of Workforce Statistics and Economic Research for the four calendar quarters ending each June 30 shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.

Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2025 shall be $1,295.

2025 Max Comp Rate Bulletin

On Wednesday, August 21 at the annual Workers’ Compensation Educational Conference hosted by WCI, the Division held its breakout session covering Legislative and Regulatory updates. Additionally, the Division panel discussed and outlined stakeholder responsibilities and impacts to claims. Below are links to the two presentations shown during this session.

• Regulatory and Legislative Update
• Panel Presentation

During the 2023 legislative session, HB 487 amended section 440.13(12), F.S., requiring the Department to publish the schedule of maximum reimbursement allowances for physician and nonhospital services on its website by July 1 of each year. Subsequently, in the 2024 legislative session, SB 362 increased the percentage of reimbursement for physician services from 110% to 175% of Medicare, and increased reimbursement for surgical procedures from 140% to 210% of Medicare.

The Department has published to its website, the 2024 maximum reimbursement allowances for physician and nonhospital services, that will go into effect January 1, 2025, incorporating both legislative amendments.

The published fee schedule incorporates Medicare’s 2024 reimbursement values and can be found on the Division’s web site here.

The Florida Commerce's Bureau of Workforce Statistics and Economic Research has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $1,259.76 for the four calendar quarters ending June 30, 2023.

Section 440.12(2), Florida Statutes (2023), expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Bureau of Workforce Statistics and Economic Research for the four calendar quarters ending each June 30 shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.

Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2024 shall be $1,260.

2024 Max Comp Rate Bulletin

The Florida Legislature has passed House Bill 487, providing legislative ratification of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2020 Edition. This Bill has been signed by the Governor.

The anticipated effective date of the Florida Division of Workers’ Compensation Reimbursement Manuals for Hospitals, 2020 Edition (Rule Chapter 69L-7.501, Florida Administrative Code) is May 25, 2023.

The Florida Division of Workers’ Compensation Reimbursement Manuals for Ambulatory Surgical Centers, 2020 Edition (Rule Chapter 69L-7.100, Florida Administrative Code) will become effective July 1, 2023.

The Florida Division of Workers' Compensation submitted a Notice of Change regarding the proposed Rule 69L-7.100, F.A.C., Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs).

See Volume 49, No. 34, in the February 20, 2023, issue of the Florida Administrative Register (F.A.R.) for a complete copy of the Notice.

The following change is made:

On Page 16, under the heading “Minimum Partial Payment Required,” the second sentence of the paragraph is amended to remove the words “for which there is no dispute as to the medical necessity.” The entire paragraph is amended to read as follows:

When a carrier denies, disallows, or adjusts payment for ASC charges, in accordance with the time limitation and coding requirements established by statute and by rule, the carrier must remit a minimum partial payment of the ASC’s charges. Minimum partial payment means payment of all non-disputed charges. The payment must accompany the Explanation of Bill Review (EOBR).

If you have questions or comments contact Mark Harrell, Medical Health Care Program Analyst, Bureau of Monitoring and Audit, at (850) 413-1726 or Mark.Harrell@MyFloridaCFO.com.

• Hearing 69L-7.730 and 69L-7.740 January 13, 2023 Audio

The DEPARTMENT OF FINANCIAL SERVICES, DIVISION OF WORKERS’ COMPENSATION announces a public meeting of the Three-Member Panel to which all persons are invited. This meeting will not be held in person.

DATE AND TIME: January 5, 2023, 4:00 – 5:00 p.m. ET

Please join the meeting from your computer, tablet, or smartphone.
https://meet.goto.com/989161421
You can also dial in using your phone.
United States (Toll Free): 1 866 899 4679
United States: +1 (571) 317-3116
Access Code: 989-161-421
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Meeting ID: 989 161 421
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GENERAL SUBJECT MATTER TO BE CONSIDERED: ; Subparagraph 440.13(12)(e)4, F.S., requires the Three-Member Panel to submit recommendations on or before January 15, 2017, and biennially thereafter, to the President of the Senate and the Speaker of the House of Representatives on methods to improve the workers’ compensation health care delivery system. ; The Three-Member Panel will consider adopting recommendations at this meeting.

Notice of this public meeting appeared in Volume 48, Number 250, ;of the Florida Administrative Register, published on December 28, 2022.

A copy of the agenda can be found here.
Biennial Report - DRAFT
Report to the Three-Member-Panel Regarding the Resolution of Medical Reimbursement Disputes

The Florida Commerce's Bureau of Workforce Statistics and Economic Research has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $1,197.43 for the four calendar quarters ending June 30, 2022.

Section 440.12(2), Florida Statutes (2022), expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Bureau of Workforce Statistics and Economic Research for the four calendar quarters ending each June 30 shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.

Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2023, shall be $1,197.

2023 Max Comp Rate Bulletin

On May 25, 2022, Governor Ron DeSantis signed HB 959 amending the requirement for workers’ compensation insurers to mail informational brochures pursuant to ;s. 440.185(3), F.S., and allowed such insurers the option to deliver the brochures by e-mail.

s. 440.185(3) ;Within 3 ;business ;days after the employer or the employee informs the carrier of an injury, the carrier shall ; send by regular mail or email ;to the injured worker an informational brochure approved by the department which sets forth in clear and understandable language an explanation of the rights, benefits, procedures for obtaining benefits and assistance, criminal penalties, and obligations of injured workers and their employers under the Florida Workers’ Compensation Law. Annually, the carrier or its third-party administrator shall ; send by regular mail or e-mail ;to the employer an informational brochure approved by the department which sets forth in clear and understandable language an explanation of the rights, benefits, procedures for obtaining benefits and assistance, criminal penalties, and obligations of injured workers and their employers under the Florida Workers’ Compensation Law. All such informational brochures shall contain a notice that clearly states in substance the following: “Any person who knowingly and with intent of injure, defraud, or deceive any employer or employee, insurance company, or self-insured program, files a statement of claim containing any false or misleading information commits a felony of the third degree.”

Effective July 1,2022, the Injured Worker Informational Brochure (DFS-F2-DWC-60 and/or DFS-F2-DWC-61) shall be mailed or e-mailed to the injured worker pursuant to s. 440.185(3), Florida Statute, and 69L-3.0035, Florida Administrative Code, and the Employer Informational Brochure (DFS-F2-DWC-65) and/or DFS-F2-DWC-66) shall be mailed or e-mailed to the employer pursuant to s. 440.185(3), Florida Statute, and 69L-3.0035, Florida Administrative Code.

The Three-Member Panel will consider adopting the methodologies for maximum reimbursement allowances. Pursuant to subsection 440.13(12), F.S., the Three-Member Panel shall annually adopt schedules of maximum reimbursement allowances for physicians, hospital inpatient care, hospital outpatient care, and ambulatory surgical centers. In addition, the Three-Member Panel will discuss possible topics to be addressed in the 2023 Biennial Report.

A copy of the agenda and related meeting documents may be found here: ;3MP-AgendaMeetingMaterialsPublic

This meeting will not be held in person.
Please join the meeting from your computer, tablet or smartphone
https://meet.goto.com/603199453

You can also dial in using your phone.
United States (Toll Free): ;1 866 899 4679
United States: ;+1 (571) 317-3116
Access Code: ;603-199-453
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Meeting ID: 603 199 453
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The Florida Division of Workers' Compensation recently participated in the 75th Annual Workers' Compensation Educational Conference with the Workers' Compensation Institute, in Orlando, Florida. ; The Division's breakout session included the following topics: Legislative and Rule Updates, Opportunities for Industry Improvement, and Medical Services Updates. If you were unable to attend or would like to view the presentations, click here..

• 69L-7.020, F.A.C. Hearing Audio 8-26-2021

• 69L-7.730 Workshop Audio 6-30-21
• 69L-7.740 Workshop Audio 6-30-21

• Hearing 69L-31 5-27-2021 Audio

• Hearing 69L-7.020 5-6-2021 Audio

• Hearing 69L-7.020 3-4-2021 Audio

• Hearing 69L-31 2-9-2021 Audio

• 3MP 1-27-2021 Audio

The DEPARTMENT OF FINANCIAL SERVICES, DIVISION OF WORKERS’ COMPENSATION announces a public meeting of the Three-Member Panel to which all persons are invited. This meeting will not be held in person.
DATE AND TIME: January 27, 2021, 3:00 – 4:00 p.m. ET
PLACE: Please join the meeting from your computer, tablet or smartphone
Please join the meeting from your computer, tablet or smartphone.
https://global.gotomeeting.com/join/298656589

You can also dial in using your phone.
United States (Toll Free): ;1 866 899 4679
United States: ;+1 (571) 317-3116
Access Code: ;298-656-589
Join from a video-conferencing room or system.
Dial in or type: 67.217.95.2 or inroomlink.goto.com
Meeting ID: 298 656 589
Or dial directly: ;298656589@67.217.95.2 ;or 67.217.95.2##298656589
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GENERAL SUBJECT MATTER TO BE CONSIDERED: ; Subparagraph 440.13(12)(e)4, F.S., requires the Three-Member Panel to submit recommendations on or before January 15, 2017, and biennially thereafter, to the President of the Senate and the Speaker of the House of Representatives on methods to improve the workers’ compensation health care delivery system. ; The Three-Member Panel will consider adopting recommendations at this meeting.
A copy of the agenda can be found here.

• 3MP 12-17-2020 Audio

• Rule chapter 69L-31 SERC