South Carolina Workers' Compensation Fee Schedule 2017: What You Need to Know

What the 2017 Schedule Covers

The South Carolina Department of Insurance published its 2017 workers' compensation fee schedule to set standardized rates for medical and other benefit costs. It applies to all covered employers and insurers in the state, providing a transparent baseline for claim payments and cost control.

Structure of the Schedule

The schedule is divided into three main sections: medical services, other benefits, and administrative fees. Each section lists specific services—such as physician visits, hospital stays, and durable medical equipment—along with a fixed dollar amount that insurers may reimburse.

Key Rates and Their Rationale

Medical services include a $60 limit for outpatient visits, $120 for emergency department care, and $350 for inpatient stays per day. Other benefits cover up to $2,500 for prescription drugs and $1,000 for durable medical equipment per claim. Administrative fees cap at 3.5% of the total benefit amount, ensuring predictable overhead costs.

Impact on Employers and Insurers

Employers benefit from cost certainty, as the schedule reduces the risk of unexpected medical expenses. Insurers use the rates to calculate premiums and reserve funds, aligning payment obligations with projected claim costs.

Compliance and Adjustments

Insurers must file annual reports confirming adherence to the schedule. Deviations require approval from the Department of Insurance and may trigger penalties. Employers and insurers often review the schedule during renewal negotiations to adjust premiums accordingly.

Comparing 2017 to Current Schedules

While the 2017 schedule set a foundation, subsequent years have introduced adjustments for inflation and changes in medical practice. Current schedules may feature higher limits—for example, outpatient visits capped at $70—and updated administrative fee percentages.

How to Access the Schedule

The full 2017 fee schedule is available on the South Carolina Department of Insurance website. Employers should download the PDF, review the relevant sections, and consult with their insurance broker to ensure alignment with policy terms.