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Workers' Compensation AgencyMichigan.gov, Official Web Site for the State of Michigan
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What's New

• Request for Service Co. and Bill Review Contact Information PDF icon

• Request for Carrier Contact Information PDF icon

• 2009 HCS Rule Updates
Effective July 7, 2009

• Procedures for Filing Annual Medical Payment Report PDF icon

• Professional Review Policy PDF icon

• 2009 Advisory Committee Meetings

Health Care Services Rules

• HCS Rules, Manuals & Fees

• Current Health Care Services Rules Administrative Code
(R 418.10101 - 418.101504)

• Health Care Services Rules Prior to May 11, 2000

Meetings and Seminars

• 2010 Advisory Committee Meetings

• 2009 Advisory Committee Meetings

Forms & Publications

• Form CMS-1500 PDF icon

• Medical Services: An Overview for Michigan Workers' Compensation PDF icon

• WC-104B (6/09) - Health Care Services Application for Mediation or Hearing (fill-in form)

• WC-117H (3/09) Provider's Report of Claim & Request for Medical Payment PDF icon

• WC-406 (6/09) Annual Medical Payment Report (fill-in form) PDF icon

• WC-590 (6/09) Application for Certification of a Carrier's Professional Health Care Review Program (fill-in form) PDF icon

• WC-739 (6/09) Carrier's Explanation of Benefits PDF icon

Other Information

• Procedures for Filing Annual Medical Payment Report PDF icon

• Professional Review Policy PDF icon

• Publication of Injured Worker's Social Security Number on the EOB

• Provider's Report of Claim & Request for Medical Payment Form

• Copying Fee Charges by Health Care Providers under a Subpoena

• Health Care Services Rule Requirement to Reimburse Providers a 3% Late Fee for Payments That Exceed 30 Days


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