In 2025, California providers must pay more to file for Independent Bill Review (IBR) to dispute improper reimbursements from payers, due to an increased IBR filing fee.

Maximus Federal Services, the private entity to which the California Division of Workers’ Compensation (CA DWC) delegates IBR, increased the IBR filing fee from $180 to $195, effective January 1, 2025.

However, providers should note that the CA DWC’s IBR web page reflects the previous IBR filing fee amount. This may potentially cause providers to inadvertently submit IBR requests to Maximus without including sufficient payment. See the details of the change below, and be sure to submit all IBR requests with the correct $195 filing fee.

CA IBR Filing Fee: $195 in 2025

In California, providers who wish to dispute the reimbursement amount the claims administrator paid for injured worker treatment must proceed as follows:

1. The provider must submit a Second Review appeal within 90 days of receiving the payer’s initial Explanation of Review (EOR).
2. If the payer sends an EOR denying the Second Review appeal, within 30 days of receiving the payer’s EOR, the provider must pay Maximus $195 to file for IBR to dispute the incorrect reimbursement.
   

Maximus requires an IBR filing fee, the amount of which has varied over the years, to consider a reimbursement dispute. When Maximus conducts an IBR and rules in the provider’s favor, California law mandates that the claims administrator reimburse the provider for the entire IBR filing fee.

As daisyNews reported previously, daisyBill received an email from Maximus in October 2024 stating (emphasis ours):

“Please be advised the IBR filing fee will increase to $195.00 effective 1/1/2025. IBR cases received on or after 1/1/2025 require a $195.00 application fee.”

CA DWC Website: Outdated Fee Amount

As of this writing, the CA DWC instructions listed on its IBR web page reflect the previous filing fee of $180. The Form IBR-1, which providers must include with their IBR requests, also lists an outdated IBR filing fee of $335.

A screenshot of the current CA DWC IBR web page is below.

Maximus Online IBR Portal Reflects Current Filing Fee

Rather than mailing the IBR request, providers may file for IBR through Maximus’ online portal.

As the screenshot below shows, the Maximus portal reflects the correct, current $195 required IBR filing fee.

We respectfully urge the CA DWC to update its web page and Form IBR-1 with the most current, accurate information to guide providers.

If providers submit an IBR request with the wrong payment amount, it may lead to extra administrative work and delay correct reimbursement.

When workers’ comp providers have correct information, they avoid needless administrative friction, allowing providers to focus their time and resources on returning injured workers to health.

daisyBill includes tools for faster, easier IBR applications—and a library of IBR decisions to bolster your case. Schedule a brief chat with us to learn more.

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