When Rhode Island workers get hurt on the job, every X-ray, hospital visit, or therapy session is part of a carefully structured payment system. Behind the scenes, the Rhode Island Workers’ Compensation Fee Schedule decides how much doctors and hospitals are paid; keeping the system fair, predictable, and transparent for everyone involved.
This schedule is not just a bureaucratic document, it is the backbone of Rhode Island’s workplace injury network. Updated each year, it protects injured employees from unfair billing and ensures medical providers get reimbursed on time and within regulated limits.
New Fee Schedules Set Standard For Worker Care in Rhode Island’s 2025 Overhaul
Rhode Island continues to update its Workers’ Compensation Fee Schedule for 2025, simplifying billing and reimbursement. The new structure helps healthcare providers, hospitals, and insurers manage workplace injury claims with transparent pricing and faster digital access to official fee lists.
With medical inflation and new treatment standards, the 2025 fee schedule ensures fair compensation aligned with national trends. Updates to therapy codes and hospital reimbursement percentages highlight Rhode Island’s effort to maintain a balanced, evolving healthcare cost model.
The Medical Advisory Board (MAB) strengthens compliance by monitoring treatment protocols, reviewing medical complaints, and managing impartial exams. Their oversight ensures ethical billing, accurate reimbursements, and steady trust between healthcare providers, employers, and workers in compensation cases.
Both the 2025 Medical and Hospital Fee Schedules are now easily available online through Rising Medical Solutions. The shift toward digital ordering and downloadable formats signals Rhode Island’s commitment to modernization, transparency, and easier access for all stakeholders.
Quick Updates On RI Workers Comp Fee Schedule
| Post For | Rhode Island Workers Compensation Fee Schedule |
| Official Authority | Rhode Island Department of Labor and Training (DLT) |
| Oversight Board | Medical Advisory Board (MAB) |
| Medical Fee Schedule | Effective January 1, 2025 |
| Hospital Fee Schedule | Effective July 1, 2025 |
| Main Focus | Transparent, fair reimbursement for workers’ comp medical services |
| Major 2025 Changes | Updated therapy codes, digital access, simplified rate charts |
| Purpose | Regulate payments for hospitals, doctors, and therapists treating work-related injuries |
| Frequency of Updates | Annually reviewed and revised |
| Enforcement Mechanism | DLT regulations and MAB review protocols |
| Contact Info | (401) 462-8100 |
| Core Benefit | Promotes fairness, reduces billing disputes, and ensures timely payment |
| 2025 Theme | Efficiency, Transparency, and Compliance in Workers’ Compensation Care |
| Access Source | Rising Medical Solutions – www.risingms.com |
| Official Update On | dlt.ri.gov |
What Exactly Is Fee Schedule?
Think of it as a price guide for workers’ compensation healthcare. It’s a comprehensive list of procedures, billing codes, and approved reimbursement amounts that apply to:
- Doctors and specialists (under the Medical Fee Schedule)
- Hospitals and surgical centers (under the Hospital Fee Schedule)
These schedules are published and enforced by the Rhode Island Department of Labor and Training (DLT). By using them, the state ensures medical costs are consistent; no matter who treats the injury or where it happens.
Why It Matters For Everyone?
- Injured Workers – Know that your care is covered under transparent, pre-set rates.
- Doctors and Therapists – Understand exactly how much each treatment or evaluation will be reimbursed.
- Employers and Insurers – Manage costs with confidence and comply with Rhode Island’s strict workers’ compensation regulations.
The fee schedule keeps all sides honest, balancing patient care with financial responsibility.
The Two Sides of Schedule
- Medical Fee Schedule
- Covers non-hospital treatments such as doctor visits, therapy, lab work, imaging, and minor procedures.
- Lists each treatment by procedure code and its maximum allowable fee.
- Updated annually, the latest version took effect 1, January 2025.
- Older versions remain archived for reference to past claims.
- Hospital Fee Schedule
- Applies to inpatient and outpatient hospital care, including ER visits and surgeries.
- Instead of flat prices, reimbursement is based on a percentage adjustment of the hospital’s charges, determined by DLT’s published tables.
- The newest edition, effective 1, July 2025 is already active and available for order or download from Rising Medical Solutions.
Key 2025 Updates
Rhode Island’s 2025 revisions introduced cleaner formatting, digital access, and enhanced rate transparency. Here’s a quick overview of the latest editions –
| Effective Date | Schedule Type | Notable Feature |
|---|---|---|
| 1 January 2025 | Medical Fee Schedule | Streamlined CPT code listings, therapy service revisions |
| 1 July 2025 | Hospital Fee Schedule | Updated reimbursement percentages, simplified categories |
| 1 July 2024 | Hospital Fee Schedule (Previous) | Comparison baseline for rate changes |
Both schedules reflect Rhode Island’s effort to modernize claim payments, reduce billing errors, and align with national healthcare cost trends.
Oversight: The Medical Advisory Board (MAB)
The Medical Advisory Board quietly plays one of the most important roles in this process. It:
- Reviews and updates treatment protocols for work-related injuries.
- Conducts impartial medical exams after 26 and 39 weeks of incapacity.
- Handles complaints against healthcare providers.
- Can disqualify a provider for repeated violations or over-billing.
Their oversight ensures that both patients and payers operate within same ethical and financial standards. Note – Contact the MAB at (401) 458-3460, One Dorrance Plaza, Providence, RI 02903.
Understanding How Reimbursement Works
Here’s a Simple Example –
Medical Procedure
A chiropractor performs a treatment listed at $200 under the 2025 schedule. The insurer must reimburse up to, but not beyond, that amount.
Hospital Service
If a hospital bills $10,000 for an inpatient stay and the DLT’s published adjustment rate for that hospital is 70%, the maximum reimbursement is $7,000.
This structure removes confusion and ensures fairness, no surprise bills or arbitrary pricing.
Why Rhode Island Updates Its Schedule Every Year
Healthcare evolves quickly; costs rise, treatments change, and billing standards shift. Rhode Island reviews and updates its fee schedules annually to –
- Reflect current market rates and inflation.
- Ensure hospitals and providers are fairly compensated.
- Prevent fraudulent or inflated billing.
- Keep employers’ workers’ comp costs stable.
DLT publishes official Information Letters each year announcing updates, rate changes, and compliance guidance for insurers and medical professionals.
How to Access or Order Fee Schedules?
Providers and insurers can view or order both printed and digital copies of the latest schedules directly from Rising Medical Solutions –
- Available Versions –
- Medical Fee Schedule – Effective January 1, 2025
- Hospital Fee Schedule – Effective July 1, 2025
- How to Access –
- Visit www.risingms.com or the DLT Workers’ Compensation website to order, download, or reference prior years’ editions.
Note – For direct help, feeschedules@risingms.com.
Avoiding Common Pitfalls
To ensure a smooth claim process –
- Check the right version year – each fee schedule has its own effective date.
- Use proper procedure codes – wrong codes can delay or reduce payments.
- Differentiate hospital vs. medical charges – mixing them up causes denials.
- Track rate adjustments annually – to stay compliant and accurate.
Even small mistakes can cost providers thousands in lost reimbursements, or delay care for injured workers.
The Bigger Picture
Rhode Island continues to be a regional leader in modernizing workers’ compensation billing. The 2025 schedules emphasize electronic access, real-time updates, and clear communication between state officials, medical providers, and insurers. By simplifying the system, the state aims to –
- Reduce disputes between providers and insurers.
- Accelerate treatment approval for injured workers.
- Keep administrative costs predictable for employers.
This approach makes Rhode Island’s workers’ compensation network one of the most transparent in New England.
Rhode Island Leads with Smarter, Simpler Workers’ Comp Fee Rules in 2025
The Rhode Island Workers’ Compensation Fee Schedule isn’t just about numbers, it’s about building trust in a system that protects both workers and employers. By setting clear reimbursement rules, enforcing transparency, and updating rates annually, the state ensures that medical care for injured employees remains fair, timely, and affordable.
For anyone involved, from HR managers to hospital billers; understanding the fee schedule is the key to navigating workers’ comp with confidence.
