Did Florida workers' comp medical prices really rise 41% in one year?

Yes. WCRI's 2026 Medical Price Index found Florida professional medical prices rose 41% from 2024 to 2025 (WCRI, May 2026), the largest single-year jump among the 36 states studied. The driver was Senate Bill 362, which lifted physician reimbursement from 110% to 175% of Medicare effective January 2025. Evaluation and management visits rose 67%; pain management injections rose 26%.

How does medical severity affect my experience mod?

Your mod compares your actual losses to expected losses over a three-year experience period. Medical costs sit inside those actual losses as paid amounts plus open reserves. When a fee schedule reset raises the price of care, open claims can be revalued higher, pushing actual losses up while expected losses stay fixed. That widening gap is what raises the mod, often before you see it at renewal.

Do open reserves get updated when a fee schedule changes?

They can. A reserve is the carrier's estimate of a claim's remaining cost. When Florida's schedule jumped 41% (WCRI, May 2026), the projected cost of future office visits, injections, and surgery on open claims rose with it. Whether a specific reserve was adjusted, and whether the adjustment matches the claim's actual treatment path, is exactly what a worksheet review examines before the value locks in at valuation.

Does a fee schedule protect my mod from medical inflation?

Over the long run it slows growth. WCRI found fee schedule states rose 19% from 2008 to 2025 versus 43% in states without one (WCRI, May 2026). But a legislated reset like Florida's SB 362 delivers a step change in a single year, not a gentle drift. Reserves set before January 2025 were built on old prices, so the exposure is timing, not just level.

Field ReportJuly 14, 2026 · 3 min read

Florida Medical Severity Mod: Is Your Worksheet Catching It?

WCRI's 2026 index shows Florida workers' comp medical prices up 41% in a single year. That fee schedule reset lands on open reserves, and open reserves are what your mod is built from.

By TraciThe Orson Group

Field Report

+41%

Florida workers' comp professional medical prices, 2024 vs 2025

WCRI MPI-WC 2026

At a glance

Florida's workers' comp professional medical prices jumped 41% from 2024 to 2025 (WCRI, May 2026), after Senate Bill 362 raised physician reimbursement from 110% to 175% of Medicare. Higher medical severity inflates open claim reserves and unit statistical values, and every reserve dollar inside your experience period feeds your mod before the calculation ever runs.

The fee schedule finally caught up with Florida's doctors. Your mod worksheet is about to catch up next.

The Workers Compensation Research Institute (WCRI) released its 2026 Medical Price Index on May 28, 2026, and Florida is the headline. Professional medical prices in the state jumped 41% from 2024 to 2025 (WCRI, May 2026), the largest single-year move in the 36-state study. For Florida construction CFOs, that number isn't a doctor-pay story. It's a reserve story. And reserves drive your experience modification rate (EMR, also called the mod).

What moved, and why it matters to your mod

Senate Bill 362 raised the maximum reimbursement for physician services from 110% of Medicare to 175%, and for surgical procedures from 140% to 210%, effective January 2025. The result showed up fast. Florida climbed from dead last on WCRI's price index (an index value of 67 in 2024) to 25th of 36 states (92 in 2025) (WCRI, May 2026).

The increase wasn't uniform. Evaluation and management visits, the routine office visits that stack up over the life of a claim, rose 67%. Pain management injections rose 26%. Major radiology barely moved, up 3% (WCRI, May 2026). Joe Paduda put it plainly: "After decades of being wildly underpaid due to the Sunshine State's abysmally low workers' comp fee schedule, 2025 saw those worthies get a major jump in pay, 41% to be precise" (Managed Care Matters, June 2026).

Higher prices per service mean higher medical severity per claim. And medical severity is the raw material your mod is built from.

The $25,000 claim that quietly becomes $30,000

Here's the mechanic. Your mod is calculated from claim values as they sit on the unit statistical report, captured at a valuation date roughly six months after your policy period ends. Those values include paid medical plus the open reserve, the carrier's estimate of what the claim will still cost.

Take a $25,000 lost-time claim with treatment still open. If the medical portion reprices 10% to 20% under the new fee schedule, that's $2,500 to $5,000 in additional expected cost, before the mod formula runs. On a claim still generating office visits and injections, the reserve should move with the schedule. When it does, the higher value flows straight into your experience period.

A single claim revalued upward doesn't just cost more. It raises the actual losses in your mod calculation while your expected losses stay fixed, and that gap is the mod.

Fee schedule states aren't immune, they're just slower

The reflex is to assume a fee schedule protects you. Over time it does. WCRI found prices in fee schedule states rose 19% cumulatively from 2008 to 2025, versus 43% in states without one (WCRI, May 2026). States with no fee schedule still run 41% to 188% higher than the fee schedule median (WCRI, May 2026).

But a one-time schedule reset like Florida's produces a step change, not a slow drift. The 41% arrived in a single year. Reserves set before January 2025 were built on the old numbers. The question isn't whether Florida medical severity is rising. It's whether the values on your worksheet reflect the new schedule or the old one.

What an audit would check

An audit checks whether the claim values on your NCCI (National Council on Compensation Insurance) worksheet match the carrier's current reserves, whether those reserves reflect the post-SB 362 fee schedule rather than stale pre-2025 estimates, and whether any claim inside your experience period has been revalued in a way that doesn't square with its actual treatment path. A reserve that has moved for the wrong reason inflates the mod as surely as one that hasn't moved at all. Most contractors we review never see the valuation until the renewal quote lands.

The 41% is real. Whether it belongs on your mod at full weight is a separate question. Send us your NCCI worksheet and we'll review it before your next renewal.