# 803 KAR 25:089: 803 KAR 25:089. Workers' compensation medical fee schedule for physicians > Kentucky · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R089 ## Section - **Citation:** 803 KAR 25:089 - **Heading:** 803 KAR 25:089. Workers' compensation medical fee schedule for physicians - **Jurisdiction:** Kentucky - **Kind:** Regulations - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** Kentucky Administrative Regulations / Title 803 (Education and Labor Cabinet) / Chapter 025 / 803 KAR 25:089 ## Text Section 1. Definitions. (1) "Medical fee schedule" means the 2024 Kentucky Workers' Compensation Schedule of Fees for Physicians. (2) "Physician" is defined by KRS 342.0011(32). Section 2. Services Covered. (1) The medical fee schedule shall govern all medical services provided to injured employees by physicians under KRS Chapter 342. (2) The medical fee schedule shall also apply to other health care or medical services providers to whom a listed CPT, HCPCS, or Transportation code, is applicable unless: (a) Another fee schedule of the Department of Workers' Claims applies; (b) A lower fee is required by KRS 342.035 or a managed care plan approved by the commissioner pursuant to 803 KAR 25:110; or (c) An insurance carrier, self-insured group, or self-insured employer has an agreement with a physician, medical bill vendor, or other medical provider to provide reimbursement of a medical bill at an amount lower than the medical fee schedule. Section 3. Fee Computation. (1) The appropriate fee for a procedure or item covered by the medical fee schedule shall be the Maximum Allowable Reimbursement (MAR) listed in the 2024 Kentucky Workers' Compensation Schedule of Fees for Physicians for those procedures or items for which a specific monetary amount is listed. (2) Procedures Listed Without Specified Maximum Allowable Reimbursement Monetary Amount. The appropriate fee for a procedure or item for which no specific monetary amount is not listed shall be determined and calculated in accordance with numerical paragraph seven (7) of the General Instructions of the medical fee schedule unless more specific Ground Rules are applicable to that service or item, in which case the fee shall be calculated in accordance with the applicable Ground Rules. (3) The resulting fee shall be the maximum fee allowed for the service provided. Section 4 isted shall be determined and calculated in accordance with numerical paragraph seven (7) of the General Instructions of the medical fee schedule unless more specific Ground Rules are applicable to that service or item, in which case the fee shall be calculated in accordance with the applicable Ground Rules. (3) The resulting fee shall be the maximum fee allowed for the service provided. Section 4. Â (1) A physician or healthcare or medical services provider located outside the boundaries of Kentucky shall be deemed to have agreed to comply with this administrative regulation if it treats a patient who is covered under KRS Chapter 342. (2) Pursuant to KRS 342.035, medical fees due to an out-of-state physician or healthcare or medical services provider shall be calculated under the fee schedule in the same manner as for an in-state physician. Section 5. Incorporation by Reference. (1) "2024 Kentucky Workers' Compensation Schedule of Fees for Physicians", July 1, 2024 Edition, is incorporated by reference. (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department of Workers' Claims, Mayo-Underwood Building 3rd Floor, 500 Mero Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m. (3) The fee schedule may be obtained directly from FAIR Health, Inc., at https://orders.fairhealth.org/. A link to FAIR Health, Inc., may be found on the Department of Workers' Claims Web site at https://elc.ky.gov/Workers-Compensation/Pages/Medical-Services.aspx. ## Nearby sections - [803 KAR 25:010 803 KAR 25:010. Procedure for adjustments of claims](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R010.md) - [803 KAR 25:012 803 KAR 25:012. Resolution of medical disputes](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R012.md) - [803 KAR 25:015 803 KAR 25:015. Issuance of citations and procedure in workers' compensation enforcement hearings](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R015.md) - [803 KAR 25:021 803 KAR 25:021. Individual self-insurers](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R021.md) - [803 KAR 25:030 803 KAR 25:030. Special fund and employer; joint liability](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R030.md) - [803 KAR 25:036 803 KAR 25:036. 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Workers' compensation pharmacy fee schedule](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R092.md) - [803 KAR 25:096 803 KAR 25:096. Selection of physicians, treatment plans and statements for medical services](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R096.md) - [803 KAR 25:101 803 KAR 25:101. Provision of workers' compensation rehabilitation services](https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R101.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_KY_KAR_T803_C025_R089. Check the current official text before relying on it. Not legal advice.