2025 Nevada Workers Compensation Medical Fee Schedule Study
ID: 74BAI-S3470
• State: Nevada
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Description
Background
The Nevada State Purchasing Division, on behalf of the Business and Industry, Division of Industrial Relations, Workers’ Compensation Section, is seeking proposals from qualified vendors to provide 2025 Nevada Workers’ Compensation Medical Fee Schedule Study services. This initiative is authorized under NRS 616C.260, which allows for the establishment and annual revision of a schedule of reasonable fees and charges for accident benefits provided to injured employees under the Nevada Occupational Disease Act.
The goal is to maintain a fee schedule that reflects current billing and reimbursement practices.
Work Details
The vendor will conduct a comprehensive benchmarking analysis using Medicare rates, paid amounts from Nevada workers’ compensation claims, and group health data. The analysis must include:
- Definition of 'paid', 'allowed', and 'billed' amounts.
- Benchmarking across all CPT code ranges including Anesthesia (00000–99999), Surgery (10000–69999), Radiology (70000–79999), Pathology & Laboratory (80000–89999), and Medicine & E/M (90000–99999).
- Identification of top 100 cost driver codes with justification for their selection.
- Recommendations for conversion factors based on RBRVS and national benchmarks for various medical services.
- Review of maximum allowable payments for inpatient care, dental services, telemedicine, emergency department facility fees, ambulance services, pharmaceuticals, home health care, durable medical equipment (DME), and independent medical evaluations (IMEs).
- Compliance with statutory requirements including documentation support for DIR and recommendations for compliance monitoring methods.
Period of Performance
The contract is expected to be effective from January 13, 2026, following Board of Examiners' approval and will last for one year.
Place of Performance
The work will be performed in Nevada as specified by the contracting agency.
Bidder Requirements
Vendors must be registered at nevadaepro.com to respond to the solicitation. They must also hold an active entity registration in sam.gov that matches their nevadaepro.com registration. Vendors are required to comply with all mandatory minimum requirements outlined in the solicitation including having a state business license unless exempted.
The Nevada State Purchasing Division, on behalf of the Business and Industry, Division of Industrial Relations, Workers’ Compensation Section, is seeking proposals from qualified vendors to provide 2025 Nevada Workers’ Compensation Medical Fee Schedule Study services. This initiative is authorized under NRS 616C.260, which allows for the establishment and annual revision of a schedule of reasonable fees and charges for accident benefits provided to injured employees under the Nevada Occupational Disease Act.
The goal is to maintain a fee schedule that reflects current billing and reimbursement practices.
Work Details
The vendor will conduct a comprehensive benchmarking analysis using Medicare rates, paid amounts from Nevada workers’ compensation claims, and group health data. The analysis must include:
- Definition of 'paid', 'allowed', and 'billed' amounts.
- Benchmarking across all CPT code ranges including Anesthesia (00000–99999), Surgery (10000–69999), Radiology (70000–79999), Pathology & Laboratory (80000–89999), and Medicine & E/M (90000–99999).
- Identification of top 100 cost driver codes with justification for their selection.
- Recommendations for conversion factors based on RBRVS and national benchmarks for various medical services.
- Review of maximum allowable payments for inpatient care, dental services, telemedicine, emergency department facility fees, ambulance services, pharmaceuticals, home health care, durable medical equipment (DME), and independent medical evaluations (IMEs).
- Compliance with statutory requirements including documentation support for DIR and recommendations for compliance monitoring methods.
Period of Performance
The contract is expected to be effective from January 13, 2026, following Board of Examiners' approval and will last for one year.
Place of Performance
The work will be performed in Nevada as specified by the contracting agency.
Bidder Requirements
Vendors must be registered at nevadaepro.com to respond to the solicitation. They must also hold an active entity registration in sam.gov that matches their nevadaepro.com registration. Vendors are required to comply with all mandatory minimum requirements outlined in the solicitation including having a state business license unless exempted.
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Overview
Opportunity Type
Contract
Opportunity ID
74BAI-S3470
Response Deadline
Oct. 20, 2025
Past Due
Date Posted
Sept. 22, 2025
Source
Pre-Bid Conference
In lieu of a pre-bid conference, vendors may submit questions via the Q and A feature here in NevadaEPro.
Est. Value Range
Experimental
$500,000 - $1,500,000
(AI estimate)
Agency Distribution
High
On 9/22/25 Department of Business and Industry in Nevada issued Contract 2025 Nevada Workers Compensation Medical Fee Schedule Study with ID 74BAI-S3470 due 10/20/25.
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Documents
Posted documents for 2025 Nevada Workers Compensation Medical Fee Schedule Study
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Classifications
Opportunity Classification
1013 - Nevada Attorney for Injured Workers
Additional Details
Source Department
753 - Nevada Attorney for Injured Workers