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Medical Treatment Guidelines (MTGs)

Last update
October 7, 2025

In New York, workers’ compensation providers must follow the state’s Medical Treatment Guidelines (MTGs) to ensure compliant, reimbursable care for injured workers.

Medical Treatment Guidelines (MTGs)

Authorized providers in New York must follow the Medical Treatment Guidelines (MTGs) when evaluating, treating, and managing care for injured workers.

The MTGs are listed and linked below for provider reference:

When to Use the MTGs

The MTGs apply in all of the following situations:

  • Initial treatment: Providers must follow the MTGs from the first visit when diagnosing and recommending care.
  • Ongoing care: All follow-up visits, therapy, and treatment plans must remain consistent with the MTGs.
  • New or existing cases: The guidelines apply whether the injury just occurred or the worker has been under treatment for some time.

If treatment falls outside the MTGs, the provider must submit a Prior Authorization Request (PAR) for approval before delivering care.

New York

Statute/Rule

Rule

New York Codes, Rules, and Regulations, Title 12, Chapter V

Section

324.2 Medical Treatment Guidelines

Subsection Text

(a) Medical treatment guidelines.

Regardless of the date of accident or date of disablement, treatment of on the job injuries, illnesses, or occupational diseases shall be consistent with the applicable medical treatment guidelines set forth herein. The operative medical treatment guidelines shall be the medical treatment guidelines in place on the date on which medical services are rendered. All treating medical providers shall treat all existing and new workers' compensation injuries, illnesses, or occupational diseases, except as provided in section 324.3 of this Part, in accordance with the following:

(1) for the lumbar and thoracic spine before November 1, 2021, the New York Mid and Low Back Injury Medical Treatment Guidelines, Third Edition, September 15, 2014 effective November 1, 2014, which is herein incorporated by reference; for lumbar and thoracic spine treatment rendered on or after November 1, 2021, the New York Mid and Low Back Injury Medical Treatment Guidelines, Fourth Edition, January 26, 2021, effective November 1, 2021, which is herein incorporated by reference;

(2) for the cervical spine before November 1, 2021, the New York Neck Injury Medical Treatment Guidelines, Third Edition, September 15, 2014 effective November 1, 2014, which is incorporated herein by reference; for cervical spine treatment rendered on or after November 1, the New York Neck Injury Medical Treatment Guidelines, Fourth Edition, January 26, 2021, effective November 1, 2021, which is herein incorporated by reference;

(3) for the knee before November 1, 2021, with the New York Knee Injury Medical Treatment Guidelines, Third Edition, September 15, 2014 effective November 1, 2014, which is incorporated herein by reference; for knee treatment rendered on or after November 1, 2021, the New York Knee Injury Medical Treatment Guidelines, Fourth Edition, January 26, 2021, effective November 1, 2021, which is herein incorporated by reference;

(4) for the shoulder before November 1, 2021, the New York Shoulder Injury Medical Treatment Guidelines, Third Edition, September 15, 2014 effective November 1, 2014, which is incorporated herein by reference; for shoulder treatment rendered on or after November 1, 2021, the New York Shoulder Injury Medical Treatment Guidelines, Fourth Edition, January 26, 2021 effective November 1, 2021, which is herein incorporated by reference;

(5) for treatment of carpal tunnel syndrome before November 1, 2021, the New York Carpal Tunnel Syndrome Medical Treatment Guidelines, Second Edition, September 15, 2014 effective November 1, 2014, which is incorporated herein by reference; and

(6) for non-acute pain before November 1, 2021, the New York Non-Acute Pain Medical Treatment Guidelines, First Edition, September 15, 2014, effective November 1, 2014, which is incorporated herein by reference; for non-acute pain treatment rendered on or after November 1, 2021, the New York Non-Acute Pain Medical Treatment Guidelines, Second Edition, March 25, 2021, effective November 1, 2021, which is incorporated herein by reference;

(7) for the hip and groin, the New York Hip/Groin Medical Treatment Guideline, First Edition, March 18, 2020, effective November 1, 2021, which is incorporated herein by reference; and

(8) for the foot and ankle, the New York Foot/Ankle Medical Treatment Guideline, First Edition, March 18, 2020, effective November 1, 2021, which is incorporated herein by reference;

(9) for the elbow, the New York Elbow Medical Treatment Guideline, First Edition, March 18, 2020 effective November 1, 2021, herein incorporated by reference;

(10) for occupational interstitial lung disease, the New York Occupational Interstitial Lung Disease Medical Treatment Guideline, First Edition, March 18, 2020, effective November 1, 2021, herein incorporated by reference; and

(11) for asthma, the New York Asthma Medical Treatment Guideline, first edition, May 12, 2020, effective November 1, 2021, herein incorporated by reference;

(12) for hand, wrist and forearm, including treatment for carpal tunnel syndrome rendered on or after November 1, 2021, the New York Hand, Wrist & Forearm Medical Treatment Guideline, first edition, May 12, 2020, effective November 1, 2021, herein incorporated by reference;

(13) for post-traumatic stress disorder and acute stress disorder, the New York Post-traumatic Stress Disorder and Acute Stress Disorder Medical Treatment Guideline, first edition, September 15, 2020, effective November 1, 2021, herein incorporated by reference; and

(14) for depression, the New York Work-Related Depression and Depressive Disorders Medical Treatment Guideline, first edition, September 15, 2020, effective November 1, 2021, herein incorporated by reference.

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