Minnesota Updates Workers’ Compensation Medical Fee Schedule for 2026–2027

Every year on October 1, the Minnesota Department of Labor and Industry (DLI) updates the state’s workers’ compensation medical fee schedule. The new schedule sets the payment rules and price limits for care provided between October 2026 and September 2027.

While fee adjustments mostly happen behind the scenes between clinics and insurance companies, these rules directly shape how you receive medical care after an injury.

Understanding how Minnesota’s fee schedule works gives you peace of mind that your treatment is covered and protects you from unexpected out-of-pocket medical bills.

What Is the Workers’ Comp Medical Fee Schedule?

The medical fee schedule sets the maximum dollar amount that medical providers can charge for treating a work-related injury. It covers nearly every step of medical recovery, including:

• Routine doctor visits and surgical procedures
• Physical therapy and rehabilitation
• Chiropractic adjustments
• Diagnostic tests and laboratory work

Under Minnesota law, a care provider is paid either the amount listed in the state fee schedule or their actual billed fee, whichever amount is lower.

For services that aren’t specifically listed in the state schedule, providers are generally reimbursed at 85% of their charged fee. Exceptions apply for smaller community hospitals with 100 beds or fewer and certain care facilities, which receive 100% reimbursement to ensure smaller communities maintain access to care.

Will You Ever Have to Pay the Difference for Medical Care?

One of the most important consumer protections in Minnesota’s workers’ compensation system involves balance billing.

If a doctor or physical therapist charges $300 for a visit, but the state fee schedule caps reimbursement at $200, the insurance company pays $200. The provider cannot bill you or your employer for the remaining $100.

• Provider charge exceeds state cap: Payment is reduced to the state maximum, meaning you do not owe the remaining balance.
• Service isn’t listed in the schedule: Paid at 85% (or 100% at small hospitals), ensuring care remains covered without surprise bills.
• Independent Medical Examination (IME): Capped under specific state fee rules, setting fees by state law regardless of who requests the second opinion.

If you ever receive a bill or balance statement from a clinic for approved workers’ comp care, it is usually a billing error that can be resolved quickly.

How the State Rules Prevent Excessive Medical Charges

To keep the system running smoothly, Minnesota statutes outline clear rules on what counts as an “excessive” medical charge. Under Minnesota law, a medical service or fee is considered excessive if:

• It exceeds the fee schedule limit: Charges above state caps are automatically reduced.
• Treatment frequency is too high: Care provided at a level, frequency, or duration above accepted medical standards can be questioned by insurers.
• Care falls outside the provider’s scope: Services must be recognized within the provider’s professional field as having direct therapeutic value for your specific injury.

These standards encourage clinics to provide reasonable, medically necessary care aimed at helping you heal and get back to work safely.

What Should You Do If You Encounter Medical Billing Issues?

While the system is designed to run quietly in the background, administrative hurdles can still happen during recovery. Here are a few simple ways to protect yourself:

1. Tell every provider it is a work injury. Always give your clinic your workers’ comp claim number, injury date, and insurer information so they bill the insurance company directly.
2. Keep copies of every medical document. Hold onto work restriction slips, treatment plans, and any explanations of benefits (EOBs) you receive in the mail.
3. Do not pay out-of-pocket for covered care. If a provider sends you a bill directly, contact your claims adjuster or seek legal guidance before sending any payment.

Trusted Guidance for Minnesota Workers Since 1961

Navigating medical approvals, insurance paperwork, and benefit limits can feel overwhelming when you are trying to recover from an injury. Since 1961, Meshbesher & Spence has stood alongside injured Minnesotans, making sure their medical care is fully covered and their rights under state law are protected.

Cases are stronger when your legal team gets involved early. If you have questions about unpaid medical bills, denied treatments, or your workers’ compensation claim, call Meshbesher & Spence today at (612) 339-9121 or fill out our online form for a free consultation.