To the extent an individual or entity wishes to rely upon information contained in this resource, such reliance should be based upon an independent legal review and analysis of applicable law. This resource was prepared for informational purposes only and is not offered or intended, nor should it be relied upon, for legal advice for any specific set of circumstances. Additional legal doctrines, federal and state statutes, and case law not set forth herein may apply to your situation and such laws, rules and regulations can vary from state to state. You should consult with your own attorney to obtain specific legal advice on your particular facts and circumstances and applicable laws, rules, and regulations.

Key Resources and Links

Agency

• Workers'Compensation Commission (WCC)

Contact Information

• Mississippi WC Key Contacts (See: Medical Cost Containment/Fee Schedule Information)

News and Updates

• See Agency home page

Other

• Claims Procedures Manual (See: Section II B – Paying and Reporting Medical Benefits)
• Fee Schedule (sold by OptumInsight)
• Agency home page

Therapy Regulations

• What is the conversion factor for outpatient therapy services?
  • Response: $64
  • Detail: Reverse calculation from schedule of max fees provided
  • Citation: https://mwcc.ms.gov/#/medicalFeeSchedule
• What is the basis of the fee schedule for outpatient therapy services?
  • Response: RBRVS
  • Detail: Unable to locate specific statute or rule
  • Citation: https://mwcc.ms.gov/#/medicalFeeSchedule
• Are there limits on the number of physical therapy visits allowed?
  • Response: Yes
  • Detail: 15 visits or 30 days without authorization, beyond that requires prior auth (based on medical necessity)
  • Citation: Physical Medicine chapter of fee schedule
• Are there limits on payment per visit for outpatient therapy services?
  • Response: Yes
  • Detail: Maximum four units per visit without prior authorization
  • Citation: https://mwcc.ms.gov/#/medicalFeeSchedule
• Do regulations require use of treatment guidelines?
  • Response: No
• Is a referral required in order to see a physical therapist?
  • Response: Yes
  • Detail: Must be prescribed by authorized treating or attending physician
  • Citation: Per Senior Attorney, WCC
• Can outpatient fees be negotiated above or below the fee schedule? ¹
  • Response: Yes + / -
  • Detail: WCRI report indicates can be negotiated above or below the published rate, but no citation located
  • Citation: https://www.mwcc.ms.gov/#/frequentlyAskedQuestions/mfs2022
• Can the injured worker be charged for any claim-related services?
  • Response: No
  • Detail: Not for treatment under the terms of the Workers' Compensation Act, see p. 20 of Claims Procedures Manual
  • Citation: https://www.mwcc.ms.gov/#/frequentlyAskedQuestions/mfs2022
• Are there workers' compensation regulations about who can provide services under the direction and supervision of a physical therapist?
  • Response: Yes
  • Detail: PT and PTA per reimbursement rules; PTA paid at 85% of PT
  • Citation: orders.fairhealth.org
• Are there provider network and/or managed care regulations in place?
  • Response: No
• Are there regulations that address which fee schedule applies if an injured worker from this state seeks treatment in another state?
  • Response: Yes
  • Detail: Out of state fee schedule applies; if no fee schedule, payment is UCR.
  • Citation: https://www.mwcc.ms.gov/#/frequentlyAskedQuestions/mfs2022
• Are there regulations regarding Functional Capacity Evaluations (FCEs)?
  • Response: Yes
  • Detail: Physical Medicine IV (B); must be prescribed by licensed physician or required by payer, when allowed; requires prior authorization; CPT 97750
  • Citation: https://www.mwcc.ms.gov/#/frequentlyAskedQuestions/mfs2022

¹ While some states use a mandatory fee schedule, many states have provisions for fees to be negotiated above or below the published fee schedule. "Yes + / - " indicates that fees can be negotiated above or below the fee schedule. "Yes -" indicates that fees can only be negotiated below the fee schedule.

The following payer types conduct business in this state.

• Private Carriers: Yes
• Self-insured Employers or Groups: Yes
• Competitive State Fund: No
• Exclusive State Fund: No
• State Comp Fund (last resort): No

The Workers' Compensation resources have been updated as of 2026.