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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. Information in this database was obtained from publicly available materials on the internet, unless otherwise noted. 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:
Department of Workforce Services
Contact Information:
307/777-5476
E-mail
News & Updates: News and Events
(News is on the main
web page)
Other:
Medical Providers
Rehabilitation Therapy Guidelines (.pdf)
Fee Schedule (.pdf)
Preauthorization Program
Treatment Guidelines
Provider Bulletins
Therapy Regulations
| Question | Response | Detail | Citation |
| What is the conversion factor for outpatient therapy services? | Yes | Therapy treatment parameters, page 29, Rehabilitation Therapy Utilization Guidelines | http://soswy.state.wy.us/Rules/RULES/8194.pdf |
| What is the basis of the fee schedule for outpatient therapy services? | Yes | Page 12, coding guidelines; 5 units 1:1 exercise, 4 units manual therapy per day | http://soswy.state.wy.us/Rules/RULES/8194.pdf |
| Are there limits on the number of physical therapy visits allowed? | Yes | Therapy treatment parameters, page 29, Rehabilitation Therapy Utilization Guidelines | http://www.wyomingworkforce.org/Documents/WSCD-CSS/Rehab%20Therapy%20Guidelines.pdf |
| Are there limits on payment per visit for outpatient therapy services? | Yes | Page 12, coding guidelines; 5 units 1:1 exercise, 4 units manual therapy per day | http://www.wyomingworkforce.org/Documents/WSCD-CSS/Rehab%20Therapy%20Guidelines.pdf |
| Do regulations require use of treatment guidelines? | No | While there are not regulations, there are many treatment guidelines published on the Department of Workforce Services website | http://www.wyomingworkforce.org/medical-providers/workers-compensation/Pages/treatment-guidelines.aspx |
| Is a referral required in order to see a physical therapist? | Yes | Page 9 Rehabilitation Therapy Utilization Guidelines "Referral/prescription" | http://www.wyomingworkforce.org/Documents/WSCD-CSS/Rehab%20Therapy%20Guidelines.pdf |
| Can outpatient fees be negotiated above or below the fee schedule? 1 | Yes, OOS only | Fee schedule applies: Chapter 9 section 1a | http://soswy.state.wy.us/Rules/RULES/8194.pdf |
| Can the injured worker be charged for any claim-related services? | No | ||
| Are there workers' compensation regulations about who can provide services under the direction and supervision of a physical therapist? | No | ||
| Are there provider network and/or managed care regulations in place? | No | ||
| Are there regulations that address which fee schedule applies if an injured worker from this state seeks treatment in another state? | Yes | Out of state fees can be negotiated: Chapter 9, Section 1a | http://soswy.state.wy.us/Rules/RULES/8194.pdf |
| Are there regulations regarding Functional Capacity Evaluations (FCEs)? | Yes | Section IV: FUNCTIONAL CAPACITY ASSESSMENT/EVALUATION | http://www.wyomingworkforce.org/Documents/WSCD-CSS/Rehab%20Therapy%20Guidelines.pdf |
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 - No
Self-insured Employers or Groups - Yes
Competitive State Fund - No
Exclusive State Fund - Yes
State Comp Fund (last resort) - No