Labor & Industries Medical Aid Rules and Fee Schedules (MARFS) for 2024

The Department of Labor & Industries has published the 2024 edition of the Medical Aid Rules and Fee Schedules (MARFS), effective July 1, 2024.

Major fee schedule updates for 2024:

• The professional fee schedule cost of living adjustment (COLA) is 1.5%.
• The facility fee schedule COLA is 1%.
• The conversion factor is $59.98.
• The anesthesia conversion factor is $58.35 per 15 minutes.
• The daily cap for both physical therapy and occupational therapy services is $147.97.
• The daily cap for massage is $110.98.

Significant policy updates:

• Chapter 2: Information for All Providers now includes clarifications for providers who have a dual license. A new section on billing protests, appeals, adjustments and rebills provides clarity on timeliness.
• Chapter 3: Ambulance, Taxi, and Other Transportation Services includes a new billing code for taxi no-shows related to insurer arranged Independent Medical Exams (IMEs) or insurer arranged consultations.
• Chapter 9: Durable Medical Equipment has been restructured to improve clarity and ease-of-use, and contains a new standalone policy for Negative Pressure Wound Therapy.
• Chapter 14: Language Access Services for Spoken Languages has been restructured to improve clarity and ease-of-use, and reflects changes to interpretation services. Sign language services are now in Chapter 22: Other Services.
• Chapter 17: Mental Health Services clarifies the differences between neuropsychological testing and psychological testing.
• Chapter 19: Naturopathic Physicians and Acupuncture Services underwent a complete overhaul and now allows naturopaths to bill CPT® for office visits and treatment. A reorganized acupuncture policy provides further clarity.
• Chapter 22: Other Services includes several new policies, including a policy specifically for lodging providers, an updated Behavioral Health and Interventions policy, and an update for the Surgical Quality Care Program. Masters Level Therapists are now part of the L&I provider network. Sign language services now reside in this chapter.
• Chapter 25: Physical Medicine Services clarifies Functional Capacity Exam billing limits. A new policy was added for Work Rehabilitation.
• Chapter 27: Reports and Forms now clarifies when 60-day reports are required.
• Chapter 30: Vocational Services includes a vocational school refund policy and revamped policies for travel and remote services.

Any further updates or corrections will be noted on the Updates and Corrections webpage. For payment policy and fee schedule questions, please contact HPPM@Lni.Wa.Gov

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