Texas workers’ comp
Code 99215 — maximum allowable reimbursement
Maximum allowable (non-facility)
$421.04
Statewide range $396.21 – $425.30 across 8 localities
Show your work — how this rate is computed
Texasprices workers’-comp physician services by the RBRVS formula (28 TAC §134.203): each RVU component is scaled by its HOUSTON GPCI, summed, then multiplied by the conversion factor.
[ (Work 2.80 × PW GPCI 1.01)
+ (PE 2.75 × PE GPCI 0.99)
+ (MP 0.21 × MP GPCI 1.38) ]
= 5.84211 adjusted RVUs
× $72.0700 conversion factor
= $421.04
- RVUs: CMS National Physician Fee Schedule Relative Value File (PPRRVU2026_Jan_nonQPP.csv) — CMS ↗
- GPCIs: CMS Geographic Practice Cost Indices (GPCI2026.csv) — by payment locality
- Conversion factor $72.0700: Texasworkers’ comp fee schedule (28 TAC §134.203) — source ↗
- Methodology verified to the penny against the CMS Physician Fee Schedule Look-Up Tool (national) and the state’s Medicare contractor (locality).