WHAT PAYERS NEED TO KNOW - ARCHIVED UPDATES
November 19, 2025
Updated Dental Fee Schedule
As part of the New York State Workers' Compensation Board's (Board's) efforts to ensure high quality care to injured workers, the Board has implemented updates to the Official New York Workers' Compensation Dental Fee Schedule. These updates will ensure fairer compensation to providers, reflect current dental practices, and promote higher-quality care for New York's injured workers.
For details on the new fee schedule, view the Adoption of Amendments to Section 444.2 of Title 12 of the NYCRR (Dental Fee Schedule).
Paid Family Leave updates for 2026
Both the maximum weekly benefit and the employee contribution rate are increasing for NYS Paid Family Leave starting January 1, 2026. See the Chair's recent announcement and the New York Paid Family Leave Updates for 2026 webpage for full details and resources you can share with your policy holders.
Important changes to Form C-8.1B
The Board has updated its Notice of Objection to a Payment of a Bill for Treatment Provided (Form C-8.1B) to require payers to provide a detailed explanation of their objections to bills for medical treatment. The form's certification statement has also been amended to indicate that copies of the form were sent to all those required by law. The changes apply to both the paper and online versions of the form.
Read more in a notification dated October 1, 2025.
New inpatient rates for acute per case inpatient rates, exempt hospital units and chemical dependency detoxification rates effective January 1, 2025
The NYS Office of Health Insurance Programs has calculated rates of reimbursement for the period January 1, 2025, through December 31, 2025, for acute per case, exempt hospital, exempt unit, and chemical dependency detoxification services.
Read more in Subject Number 046-1773.
Claimant IMEs - cost and disbursements
A claimant may obtain an Independent Medical Examination (IME) from a medical provider other than their own treating provider for evidentiary purposes in a workers' compensation proceeding. If a claimant's representative pays for an elective IME and then seeks reimbursement from the claimant, those payments or requests for reimbursement are outside of the Board's jurisdiction.
Read more in a notification dated Novemver 17, 2025.
New York State Workers' Compensation Board announces 2026 Assessment Rate
Pursuant to WCL §151, the Chair of the New York State Workers' Compensation Board (Board) shall annually establish an assessment rate for all employers by November 1 of each year, to be effective January 1 of the subsequent calendar year.
Read more in Subject Number 046-1781.
Reminders
The What Payers Need to Know section of the Board's website walks payers through getting started in the workers' compensation system, becoming a trading partner, administering claims, and more.
Electronic submission of the CMS-1500 form is mandatory. Visit CMS-1500 initiative for more details and send your questions to CMS1500@wcb.ny.gov.
Visit the Board's website for OnBoard training guides, webinar recordings, and other resources.
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The latest versions of several Paid Family Leave presentations are available, including family care, foster care/adoption, military leave, and bonding. Visit the Paid Family Leave website for more information.
Stay informed!
Check out What Payers Need to Know on the Board's website for recorded webinars and guides.
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