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Alaska Workers Compensation 2019 Update

Wednesday, February 6, 2019   (0 Comments)
Posted by: Sheri Ryan
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Chiropractic Society

AK Work Comp Update


Change is Inevitable (and a given with AK Work Comp)

The Medical Services Review Committee (MSRC) with the Alaska Workers' Compensation Board, met over the summer of 2018.  This committee is tasked with addressing the high medical costs under the workers compensation program and making recommendations to the AK Work Comp Board. Dr. Christopher Twiford, Kodiak, represented the Alaska Chiropractic Society on the committee for 2018.  As an interested party, I also attended the many public meetings. The AK Work Comp Board voted to accept the MSRC recommendations at their October, 2018 board meeting with those changes effective 01/01/2019.

Once again, the biggest highlight of the MSRC recommendations was a reduction to the conversion factors used to determine the fee for service. Here's my bird's eye overview of the meetings - A 5% reduction for all conversion factors over 126 will result in 2% overall spend reduction in the work comp program. No proposed reduction in the conversion factor used to determine inpatient or outpatient hospital expenses recommended. Surgery reimbursement was reduced from $174 to $165, radiology from $206 to $196 and Lab/Pathology from $142 to $135. All other conversion factors to remain the same. 

The MSRC also addressed the incorrect way that the multiple procedure payment reduction (MPPR) was being calculated by AK Work Comp and made the recommendation that work comp follow code specific CMS guidelines as opposed to the current 100/50/50/50 when modifier 50/51 are used.  

The MSRC will meet again in summer, 2019 and is tasked with considering larger scale conversion factor reductions across the board in order to bring work comp spend down. Magical number is 126 -- doubtful that E/M and medicine conversion factors would increase from 80 to 126 as any savings in reducing other conversion factors (surgery, radiology, pathology/lab, anesthesia) would be outweighed by increase due to frequency of these type of services (E/M + medicine). Work comp will most likely end up with two rather than one overall conversion factor.   But, it would mean BIG reductions for radiology and surgery services. Inpatient services currently at $221.79 conversion factor. Outpatient and ambulatory surgery centers have not had any cuts since RBRVS adopted in December, 2015.

Changes in the world of Alaska Workers' Compensation - 

  • Official Alaska Workers' Compensation Medical Fee Schedule effective January 1, 2019 - this should really be called the General information and guidelines for AK work comp....
  • Radiology conversion factor reduced from $206 to $196
  • Surgery conversion factor reduced from $174 to $165
  • Lab/Pathology conversion factor reduced from to $142 to $135
  • Modifier 51 - Consistent with the Centers for Medicare and Medicaid Services (CMS) guidelines, code-specific multiple procedure reduction guidelines apply to endoscopic procedures, and certain other procedures including radiology, diagnostic cardiology, diagnostic ophthalmology, and therapy services.  
  • ACS AK Work Comp Commonly Used Chiropractic CPT Code Fee Schedule Spreadsheet NOW AVAILABLE!  Download your copy NOW!  
  • Dr. Tamika Ledbetter now serves as the new Commissioner of the Department of Labor and Workforce Development. Under her leadership, the Department serves to provide safe and legal working conditions and advance opportunities for employment. She held several key positions with the Department prior to becoming Commissioner, including Regional Manager for the Anchorage/Mat-Su Economic Region.  Dr. Ledbetter replaces Heidi Drygas as commissioner. 
  • Grey Mitchell is the new Director, Alaska Workers Compensation.  He replaces Marie Marx as director.  Mr. Mitchell is the previous Director, Labor Standards and Safety for the division that encompasses the Occupational Safety and Health, Mechanical Inspection, Wage and Hour and Safety Advisory Council components for the State of Alaska.  
  • Dr. Christopher Twiford has been appointed to serve on the Alaska Workers Compensation Board effective March 1, 2019 through March 1, 2021.  Dr. Twiford has been practicing chiropractic for over 20 years with over 11 years spent serving patients in rural Alaska. Dr. Twiford comes from a chiropractic family- in fact it was in 1986 at the age of 13 when he first knew he wanted to become a chiropractor after seeing his Uncle Bill adjust some family members. Dr. Twiford attended Old Dominion University in Norfolk, Virginia and then entered Texas Chiropractic College in 1993. Upon graduating in 1997, Dr. Twiford practiced in Houston, TX for 8 years before moving to Bethel, Alaska in 2006. Dr. Twiford quickly took to living in small town rural Alaska and spent the next 11 years growing Arctic Chiropractic in Bethel. In 2017, he decided he would relocated to Kodiak to offer his uniquely Alaskan brand of services to the good people on that island.  

The Alaska Chiropractic Society has put together a spreadsheet of the most commonly used CPT codes in chiropractic offices. The 2019 AK Work Comp Fee Schedule can now be accessed on under the Members Only tab. You will need to login as a current member to view, download and print the fee schedule. The fee schedule also compares the 2019 rates vs. the 2018 rates and displays the rate of increase/decrease.  If there is a CPT code not listed that you need calculated, please email  

Having problems accessing your account? Need to renew your membership for 2019? Contact Sheri Ryan at 907.903.1350 or 

Our continued goal is to provide our member doctors and their staff with current information to keep you up to date of the many changes in the world of AK Work Comp. If you have any questions or concerns, give ACS a call at 907.903.1350 or email


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Alaska Chiropractic Society, PO Box 111507, Anchorage, AK  99511-1507 
Phone: (907) 903-1350   Fax:  (907) 770-3790   Email: