Ind. Code » Title 22
Indiana Code

Ind. Code § 22-3-3-5 (2025)

Medical treatment; liability of estate; right to order payment; medical service provider claims; attending physician fees

✓ 2025 Indiana Code: the 2026 session is not included
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     Sec. 5. (a) The pecuniary liability of the employer for a service or product herein required shall be limited to the following:

(1) This subdivision applies before July 1, 2014, to all medical service providers, and after June 30, 2014, to a medical service provider that is not a medical service facility. Such charges as prevail as provided under IC 22-3-6-1(k)(1), in the same community (as defined in IC 22-3-6-1(h)) for a like service or product to injured persons.

(2) This subdivision applies after June 30, 2014, to a medical service facility. The amount provided under IC 22-3-6-1(k)(2).

     (b) The employee and the employee's estate do not have liability to a health care provider for payment for services obtained under IC 22-3-3-4.

     (c) The right to order payment for all services or products provided under IC 22-3-2 through IC 22-3-6 is solely with the board.

     (d) All claims by a medical service provider for payment for services or products are against the employer and the employer's insurance carrier, if any, and must be made with the board under IC 22-3-2 through IC 22-3-6. After June 30, 2011, a medical service provider must file an application for adjustment of a claim for a medical service provider's fee with the board not later than two (2) years after the receipt of an initial written communication from the employer, the employer's insurance carrier, if any, or an agent acting on behalf of the employer after the medical service provider submits a bill for services or products. To offset a part of the board's expenses related to the administration of medical service provider reimbursement disputes, a medical service facility shall pay a filing fee of sixty dollars ($60) in a balance billing case. The filing fee must accompany each application filed with the board. If an employer, an employer's insurance carrier, or an agent acting on behalf of the employer denies or fails to pay any amount on a claim submitted by a medical service facility, a filing fee is not required to accompany an application that is filed for the denied or unpaid claim. A medical service provider may combine up to ten (10) individual claims into one (1) application whenever:

(1) all individual claims involve the same employer, insurance carrier, or billing review service; and

(2) the amount of each individual claim does not exceed two hundred dollars ($200).

     (e) The worker's compensation board may withhold the approval of the fees of the attending physician in a case until the attending physician files a report with the worker's compensation board on the form prescribed by the board.

Formerly: Acts 1929, c.172, s.26. As amended by P.L.170-1991, SEC.4; P.L.216-1995, SEC.1; P.L.258-1997(ss), SEC.4; P.L.168-2011, SEC.3; P.L.275-2013, SEC.4.

 

Notes of Decisions
Cited in 6 cases, 1982–2011 · leading case: Christopher R. Brown v. Decatur Cnty. Mem'l Hosp., 892 N.E.2d 642 (Ind. 2008).
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Christopher R. Brown v. Decatur Cnty. Mem'l Hosp., 892 N.E.2d 642 (Ind. 2008). · cites it 6× “Ind.Code §§ 22-3-3-5, -5.1 (2004). Healthcare charges are subject to the approval of the Worker's Compensation Board, id.”
Talas v. Correct Piping Co., 435 N.E.2d 22 (Ind. 1982). · cites it 2× “The award shall be computed from May 13, 1979; 3 the weekly scope of the award shall equal the average number of hours Talas’s wife is and was working per week, and the hourly rate shall be determined in accordance with Ind.Code § 22-3-3-5 (Burns 1974). Included within the award…”
Washington Twp. Fire Dep't v. Beltway Surgery Ctr., 911 N.E.2d 590 (Ind. Ct. App. 2009). · cites it 3× “Indiana Code Section 22-3-3-5 states in part: The pecuniary liability of the employer for medical, surgical, hospital and nurse service herein required shall be limited to such charges as prevail as provided under IC 22-3-6-1(j), in the same community (as defined in IC…”
Spangler, Jennings & Dougherty P.C. v. Indiana Ins., 729 N.E.2d 117 (Ind. 2000). · cites it 2× “See Ind.Code Ann. § 22-3-3-5 (West Supp.1999).”
Indiana Spine Grp. v. Pilot Travel, 959 N.E.2d 789 (Ind. 2011). · cites it 2× “The amended statute provides in relevant part: All claims by a health care provider for payment for services are against the employer and the employer's insurance carrier, if any, and must be made with the board under IC 22-3-2 through IC 22-3-6.”
Wernle, Ristine & Ayers v. Yund, 758 N.E.2d 558 (Ind. Ct. App. 2001). · cites it 2× “Citing Indiana Code Section 22-3-3-5, we determined that St. Mary's claim for payment "above that voluntarily provided by the employer's insurer should have been addressed to the worker's compensation board.”
Ind. Code § 22-3-3-5(d): 1 case
Indiana Spine Grp. v. Pilot Travel, 959 N.E.2d 789 (Ind. 2011). “The amended statute provides in relevant part: All claims by a health care provider for payment for services are against the employer and the employer's insurance carrier, if any, and must be made with the board under IC 22-3-2 through IC 22-3-6.”
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