Circular Letter No. 5 (1995)

March 6, 1995


All Automobile Self Insurers and Insurers Licensed to Write Automobile Insurance in New York State


No- Fault Reimbursement Schedules for Hospital Services Including Ambulatory Surgery:

(A) Ambulatory Surgery Services;

(B) Outpatient Hospital Services;

(C) Inpatient Hospital Services

The Workers' Compensation Board has promulgated an Ambulatory Surgery Fee schedule. The schedule covers ambulatory surgery hospital charges rendered on or after January 1, 1995. Pursuant to Regulation No. 83, 11 NYCRR 68.2, the No-Fault rate schedules for reimbursing hospital services provided under § 5102(a)(1) of the Insurance Law shall be as follows:

(A) ambulatory surgery services, as established for workers" compensation by the Chair of the Workers" Compensation Board, pursuant to Section 13, paragraph (a) of the Workers' Compensation Law;

(B) outpatient services, as established for workers' compensation by the Chair of the Workers" Compensation Board (WCB), in conformity with Chapter 453 of the Laws of 1984; and

(C) inpatient services, in conformity with Section 2807-c of the Public Health Law.

No-Fault insurers must utilize the above referenced schedules to reimburse New York State hospitals for both inpatient and outpatient treatment and ambulatory surgery services rendered to injured parties involved in No-Fault related automobile accidents.

Requests for the Ambulatory Surgery Fee Schedule and the Outpatient Hospital Fee Schedule may be forwarded to:

State of NY Workers' Compensation Board
Administrative Services Bureau
100 Broadway-Menands
Albany, NY 12241

The ambulatory surgery fee schedule is available from the WCB in diskette form for a fee of $20.00.

Requests for the Inpatient Hospital Fee Schedule may be forwarded to:

Mr. Donald Mac Donald, Director
c/o State of New York Health Department
Empire State Plaza -- 2230 Corning Tower
Albany, NY 12237 Telephone # (518) 474-8734