This fee calculator is provided for informational purposes only to assist in determining the Maximum Allowable Reimbursement (MAR) rate. These rates may not necessarily apply if you have a contract with a carrier and providers should always verify.
The formula used to calculate the MAR is provided by the Texas Department of Insurance (TDI) and the Texas Division of Workers’ Compensation (DWC). The formula is as follows (Work RVU*Work GPCI) + (Practice RVU*Practice GPCI) + (Malpractice RVU*Malpractice GPCI)*DWC conversion factor. The DWC conversion factor is $56.82 (2016).
The RVU and GPCI values used to calculate the MAR were obtained from the Novitas Medicare fee schedule. Some procedures (such as FCE, Work Conditioning, and Work Hardening) are reimbursed as specified in DWC Rules and Policies. Reimbursement for services should always be supported by documentation.
Questions regarding the MAR Calculator should be directed to Stacey Mather, TPTA staff, at (512) 477-1818 or firstname.lastname@example.org.