Every so often, daisyNews reminds providers that it is never (never!) advisable to accept a credit card payment for an injured worker’s treatment, which payers often send in the form of Virtual Credit Cards (VCCs).

Credit cards make sense for group health copays and deductibles. Those balances are small and owed by the patient, and swiping a card beats mailing out statements and chasing patients for payment.

Workers’ comp is different. The injured worker owes nothing. The claims administrator pays the entire bill in a single payment, on deadlines set by state law. A workers’ comp credit card doesn’t solve a payment problem; it only creates new ones:

•  Bigger bills, bigger fees: VCC fees reportedly run as high as 7% of the full bill reimbursement amount. For the examples below, VCC costs can add up to $93,000 per year.
•  More administrative work: Staff must manually key in every VCC number for the exact amount before it expires. Standard Electronic Funds Transfer (EFT) payments simply land in the bank.

These VCC problems are not the byproduct of any added benefits in payment speed or security. VCC payments only benefit credit card companies, payment vendors, and payers (via rebates and revenue sharing), at the provider’s expense.

As one daisyNews reader recently put it:

"If Einstein said that compounding interest is the 8th Wonder of the World, then VCC Payments are the 8th Horror of the World. Compounding interest makes every dollar work for you. Virtual-card makes every dollar work against you."

There’s no evidence Einstein ever said the above about compound interest, but the reader’s point stands. The VCC arithmetic proves it.

Today, we break down the math. Using 2026 California Official Medical Fee Schedule (OMFS) rates for Los Angeles County and hypothetical monthly volumes, we show just how much VCCs can cost providers for:

1. Evaluation and Management (E/M) code CPT 99214
2. Carpal tunnel surgery, billed under CPT 64721

Providers, share this article with your billing staff with instructions to never accept VCC payments. If your office accepts VCCs and needs help getting out of these arrangements, contact our team at info@daisybill.com. Client or not, we’re here to help.

Credit Card Fees: E/M Services

CPT 99214 is the bread-and-butter code for E/M services for established patients, which makes it one of the most common codes on workers’ comp bills. Providers substantiate these visits with mandatory, payable PR-2 progress reports, billed with WC002.

As the table below shows, a Los Angeles County provider who accepts a VCC for a 99214/WC002 combo, reimbursed at $246.20 under the 2026 OMFS, pays $8.62 at a 3.5% fee (which is on the low end), $13.54 at 5.5%, and $17.23 at 7%.

…and that’s for a single bill.

At 300 workers’ comp E/M visits per month, if the practice is taking VCC cards for payment, the practice loses $2,585 to $5,170 every month. Over a year, that’s $31,021 to $62,042 in VCC fees.

And for what? The claims administrator must pay the bill either way, on a state-mandated deadline.

Credit Card Fees: Carpal Tunnel Surgery

The damage isn’t limited to routine office visits. Common occupational injuries like carpal tunnel syndrome often require surgery, and higher-value services mean higher VCC fees.

For a single carpal tunnel release in Los Angeles County, billed with CPT 64721, the surgeon’s professional fee under the 2026 OMFS is $820.16. VCC fees on that payment run from $28.71 to $57.41.

A practice performing 45 of these surgeries per month and accepting VCCs loses $1,292 to $2,584 monthly, or $15,501 to $31,002 per year.

Combined, a practice offering both services would hand over roughly $46,500 to $93,000 per year in VCC fees.

Credit Card Losses Are Optional

EFT payments are just as fast, and state law dictates payment deadlines regardless of method. Data from millions of bills in daisyBill’s Claims Administrator Directory show that electronic bills (e-bills) get paid in less than ten working days.

Moreover, VCCs are no more secure than EFT or paper checks, since “card not present” transactions are considered higher risk (which is part of the reason VCC fees can be higher).

Payers cannot require providers to accept VCCs, and fee-free alternatives (EFT and paper checks) are always available. Accepting a VCC means accepting pointless financial damage with no benefit to the practice.

Unfortunately, payers can send VCCs whether providers ask for them or not, and staff often run them without realizing the cost. Worse, some VCC vendors treat running even a single card as an agreement to enroll automatically, so a single key-in can undo a practice’s opt-out.

Take our reader’s advice and opt out of VCCs. daisyBill is here to help.

daisyBill gets providers paid in less than 10 days on average. Click to see how:

BILL BETTER: DAISYBILL