EOEEA_Revised_Compensation_and_Pricing.pdf
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- Attached to
- Independent Medical Examination (IME) RFR
- Solicitation number
- BD-27-1042-ENV-ENV01-133439
- Issued by
- Massachusetts
About this file
This is a compensation and pricing schedule document for the Commonwealth of Massachusetts Executive Office of Energy and Environmental Affairs (EOEEA) Independent Medical Examination (IME) and managed care services contract. The document establishes the pricing framework and submission requirements for qualified medical examination providers conducting workers' compensation evaluations across multiple medical specialties. Vendors must submit proposed rates for IME services, medical cost containment, and managed care services, with pricing structured by medical specialty and service complexity. The pricing grid covers eleven primary medical specialties including Orthopedic Surgery, Orthopedic Hand Surgery, Neurology, Neurosurgery, Psychiatry, Psychology, Ophthalmology, Pain Management, Occupational Medicine, and Physical Medicine, with provisions for additional specialties subject to EOEEA approval. Responses to the RFR are due October 6, 2026.
All bidders must provide itemized pricing for services including standard and complex IMEs stratified by medical record volume (fewer than 250 pages, 250-500 pages, and more than 500 pages), addenda involving new information, no-show fees, cancellation fees, interpreter services, physician hearing testimony and depositions, and fitness-for-duty evaluations. Additional managed care services requiring separate pricing schedules include Drug Utilization Review, Nurse Case Management with hourly rates and travel costs, diagnostic testing scheduling and coordination, medical bill review, and Utilization Review services. The Commonwealth specifies that EOEEA will cancel appointments within 48 hours at no fee to the vendor, no additional payment will be made for addenda addressing information provided at the time of original IME request, and complex IME fees including out-of-state examinations must be negotiated and approved in advance on a case-by-case basis with no fee negotiations permitted post-examination. All proposed rates are subject to EOEEA review and approval, with vendors required to clearly identify billing methodology and any applicable additional charges.
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Other files
| File | Type | Posted |
|---|---|---|
| Instructions Standard Contract Form~2.pdf | ||
| Standard Contract Form~1.pdf | ||
| Addendum 2~24.pdf | ||
| Commonwealth Terms and Conditions Form~1.pdf | ||
| Prompt Pay Discount form~2.pdf | ||
| Addendum 1~49.pdf | ||
| IME RFR~1.pdf |
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Text version
3.6 Compensation Structure and Pricing
Vendors must submit their best possible pricing for Independent Medical Evaluation (IME), medical cost containment, and managed care services. EOEEA recognizes that service costs may vary based on medical specialty, level of complexity, volume of medical records requiring review, physician availability, and the nature of the services provided. Routine and straightforward services should be priced accordingly.
Vendors shall complete the applicable pricing grids for each medical specialty and provide separate, itemized pricing for all additional services. Proposed pricing shall address, as applicable, the following:
• Standard and complex IMEs
• No-show and late cancellation fees
• Interpreter services
• Medical record reviews
• Addenda involving new information or medical reports provided after the original IME
• Transportation services
• Physician depositions and attendance at Department of Industrial Accidents (DIA) proceedings
• Fitness-for-duty and return-to-work evaluations
• Medical bill review services
• Utilization review (UR) services
• Drug Utilization Review (Drug UR)
• Nurse Case Management services and associated fees
• Diagnostic testing scheduling and coordination fees
Fees for complex IMEs, including out-of-state examinations, shall be negotiated and approved in advance on a case-by-case basis. No fee negotiations will be conducted following completion of the examination. No additional payment will be made for an addendum or clarification addressing information or questions provided at the time of the original IME request.
All bidders must submit proposed rates by specialty using the revised IME pricing grid and provide separate, itemized pricing for managed care and additional services as outlined below.
A. IME Pricing Schedule by Specialty Enter one proposed rate per service category for each specialty. Tier 1, Tier 2, and Tier 3 designations have been removed.
Specialty Service / record volume Proposed rate Orthopedic Surgeon Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Specialty Service / record volume Proposed rate
Physician hearing testimony/deposition (hourly) $________ Orthopedic Hand Surgeon Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Neurologist Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Neurosurgeon Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Psychiatrist Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Psychologist Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Specialty Service / record volume Proposed rate
Physician hearing testimony/deposition (hourly) $________ Ophthalmology Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Pain Management Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Occupational Medicine Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Physical Medicine Medical records: fewer than 250 pages $________
Medical records: 250–500 pages $________
Medical records: more than 500 pages $________
Addendum (new information) $________
No-show by injured worker $________
Cancellation by EOEEA within 48 hours NO FEE
Interpreter services (hourly) $________
Physician hearing testimony/deposition (hourly) $________ Other medical specialties may be proposed separately and are subject to EOEEA review and approval.
B. Additional Managed Care Services – Pricing Schedule Service category Pricing unit Proposed rate Drug Utilization Review Per review $________ Nurse Case Management Hourly rate $________
Service category Pricing unit Proposed rate Nurse Case Management – travel Hourly rate or mileage $________ Diagnostic testing scheduling Per scheduled appointment $________ Diagnostic testing coordination Per service/request $________ Medical bill review Per bill or transaction $________ Utilization review Per review $________
Vendors shall clearly identify their proposed rates, billing methodology, and any applicable additional charges for each service. All proposed fees shall be subject to EOEEA review and approval.
Services not specifically listed in the pricing schedules must be separately identified and itemized in the bidder’s Cost Proposal.
| A. IME Pricing Schedule by Specialty |
| B. Additional Managed Care Services – Pricing Schedule |
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