By using this site, you are consenting to our use of cookies. To find out more visit our privacy policy.
This summary sets forth various workers' compensation regulations regarding outpatient physical therapy services. The Workers' Compensation State Regulations resource may serve as a tool to assist in locating regulations. Please send database comments and corrections to advocacy@apta.org.
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/Links
Agency:
Workers' Compensation Court
Contact Information:
Nebraska WCC Contacts
News & Updates: What's New
Request E-mail Notifications
Other:Fee Schedules
Therapy Regulations
>| Question | Response | Detail | Citation |
| What is the conversion factor for outpatient therapy services? | $48.23 | See Workers Compensation Court Medical Services Fee Schedule, click through to download "Complete Schedule of Fees for Medical Services" | https://www.wcc.ne.gov/apps/IPUBA0008Jfrm.aspx |
| What is the basis of the fee schedule for outpatient therapy services? | RBRVS | Unit values listed with code in the Medical Services fee schedule | https://www.wcc.ne.gov/apps/IPUBA0008Afrm.aspx |
| Are there limits on the number of physical therapy visits allowed? | No | None reported in Physical Medicine Ground Rules (Schedule of Fees for Medical Services) | https://www.wcc.ne.gov/apps/IPUBA0008Afrm.aspx |
| Are there limits on payment per visit for outpatient therapy services? | Yes | See rule 3 multiple services rule in Physical Medicine Ground Rules (3 highest at 100%; subsequent at 50%) | https://www.wcc.ne.gov/apps/IPUBA0008Gfrm.aspx |
| Do regulations require use of treatment guidelines? | No | ||
| Is a referral required in order to see a physical therapist? | Yes | Must be referred by a physician; paragraph 3 of Physical Medicine Ground Rules | https://www.wcc.ne.gov/apps/IPUBA0008Gfrm.aspx |
| Can outpatient fees be negotiated above or below the fee schedule? 1 | Yes + / - | Instruction 9 in Schedule of Fees for Medical Services; requires written explanation, including reason; and identify person/entity that determined reduction and person/entity responsible for payment, and contact information | https://www.wcc.ne.gov/apps/IPUBA0008Afrm.aspx |
| Are there workers' compensation regulations about who can provide services under the direction and supervision of a physical therapist? | No | Physical Medicine Ground rules provide for PT and PTA | https://www.wcc.ne.gov/apps/IPUBA0008Jfrm.aspx |
| Are there provider network and/or managed care regulations in place? | Yes | RS2007 Section 48-120 and 120.02 and Rules of Procedure 51-61 | http://uniweb.legislature.ne.gov/laws/browse-chapters.php?chapter=48 http://www.wcc.ne.gov/publications/rules.pdf |
| Are there regulations that address which fee schedule applies if an injured worker from this state seeks treatment in another state? | Nebraska fee schedule applies | ||
| Are there regulations regarding Functional Capacity Evaluations (FCEs)? | No | ||
| Are there workers' compensation regulations about who can provide services under the direction and supervision of a physical therapist? | X | X | X |
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