Every state runs its own workers' comp system: its own forms, fee schedules, filing deadlines, and dispute machinery. This hub collects the professional-billing facts that decide whether you get paid — sourced, dated, and maintained.
| State | System | Timely filing | Underpayment process | Provider e-billing |
|---|---|---|---|---|
| Ohio | Monopolistic (BWC) via employer's MCO | 1 year | Rebill/adjustment to the MCO; BWC ADR escalation | Fax standard |
| California | Private carriers + SCIF; OMFS fee schedule | 12 months | Second Bill Review (SBR-1) within 90 days of EOR → Independent Bill Review, $195 fee, 30 days | Payers must accept e-bills |
| Texas | Private + Texas Mutual; DWC fee guideline | 95 days (harshest) | Carrier reconsideration → MFDR (DWC-060) within 1 yr of DOS; appeal via DWC-045M in 20 days | Payers must accept e-bills |
| New York | Private + NYSIF; WCB fee schedule; CMS-1500 mandated since 2022 | Per WCB rules | CARC-coded objections; Form HP-1.0 via OnBoard | Mandatory for providers since Aug 2025 |
| Washington | Monopolistic (L&I); MARFS updated each July 1; private VRCs bill L&I vocational codes | Per L&I rules | L&I review processes | L&I channels |
| Minnesota | Private carriers; QRCs bill hourly at DLI-capped rate (indexed annually) | Per DLI rules | DLI dispute processes | Payers must accept e-bills |
| Georgia | Private carriers; SBWC rehab-supplier fee schedule (hourly) | Per SBWC rules | SBWC processes | Payers must accept e-bills |
Roughly a dozen states now require payers to accept electronic bills (CA, GA, IL, LA, MN, NY, NC, ND, OR, TN, TX, VA), and New York and Colorado now require providers to submit electronically. Four states are monopolistic — employers must insure through the state fund: Ohio, Washington, Wyoming, North Dakota. Ohio is unique in routing bills through employer-selected MCOs.
About this reference: compiled from state statutes, agency publications, and form instructions; last reviewed July 2026. It is practitioner reference material, not legal advice — verify against current agency publications before relying on any deadline. Med Claims Pro's Ohio edition ships today; Washington, Minnesota, and Georgia editions are in development — tell us your state and we'll prioritize by demand.
The form is (nearly) universal — New York even abolished its 12 proprietary forms in favor of it — but each state controls box-level completion rules, required attachments, fee schedules, deadlines, and dispute machinery. The form is the easy part; the rules around it are the product.
Our research points to Washington first (private vocational rehab counselors billing L&I on state-specific codes — the closest analog to Ohio), then Minnesota and Georgia. But real demand decides: interest-list signups per state directly set the roadmap.
The Starter and Professional tiers work anywhere the CMS-1500 does — custom payers and rates are configurable. What state editions add is the built-in fee schedule, code sets, forms, and deadline handling.