Class 1…..$ 519 Class 3….$ 2,078
Class 2…..$ 935 Class 4….$ 3,428
(f) For a physician for whom this state is not a principal place of practice:
Class 1…..$ 433 Class 3….$ 1,732
Class 2…..$ 779 Class 4….$ 2,858
(g) For a nurse anesthetist for whom this state is a principal place of practice: $ 213
(h) For a nurse anesthetist for whom this state is not a principal place of practice:……………………………………………………………………………………………$ 107
(i) For a hospital, all of the following fees:
1. Per occupied bed………………………………………………………………………$ 52
2. Per 100 outpatient visits during the last calendar year for which totals are available:………………………………………………………………………………………….$ 2.61
(j) For a nursing home, as described under s. 655.002 (1) (j), Stats., that is wholly owned and operated by a hospital and that has health care liability insurance separate from that of the hospital by which it is owned and operated: Per occupied bed……………………………………………………………………….…..$ 10
(k) For a partnership comprised of physicians or nurse anesthetists, organized for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:
1. a. If the total number of partners and employed physicians and nurse anesthetists is from 2 to 10…………………………………………………………………………………………$ 30
b. If the total number of partners and employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………..$ 299
c. If the total number of partners and employed physicians and nurse anesthetists exceeds 100……………………………………………………..……………………………..…$ 744
2. The following fee for each full-time equivalent allied health care professional employed by the partnership as of the most recent completed survey submitted:
Employed Health Care Professionals Fund Fee
Nurse Practitioners……………………………………………………..………………..….$ 216
Advanced Nurse Practitioners……………………………………….……………..…………303
Nurse Midwives………………………………………………………..…..…………………1,903
Advanced Nurse Midwives………………………………………………..…………………1,990
Advanced Practice Nurse Prescribers ………………………………..…………..…………..303
Chiropractors……………………………………………………………………………..……...346
Dentists…………………………………………………………………..………………..……..173
Oral Surgeons……………………………………………………………………..…………..1,298
Podiatrists-Surgical…………………………………………………….………………..……3,678
Optometrists………………………………………………………..…………..……………….173
Physician Assistants……………………………………………………………………..…..173
(L) For a corporation, including a service corporation, with more than one shareholder organized under ch. 180, Stats., for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees: 1. a. If the total number of shareholders and employed physicians and nurse anesthetists is from 2 to 10……………………………………………………………...…….$ 30
b. If the total number of shareholders and employed physicians and nurse anesthetists is from 11 to 100…………………………………………………………..……$ 299
c. If the total number of shareholders and employed physicians or nurse anesthetists exceeds 100……………………………………………………….…………….$ 744
2. The following fee for each full-time equivalent allied health care professional employed by the corporation as of the most recent completed survey submitted:
Employed Health Care Professionals Fund Fee
Nurse Practitioners…………………………………………….………………………….$ 216
Advanced Nurse Practitioners………………………………..……..………………………303
Nurse Midwives………………………………………………..……………………………1,903
Advanced Nurse Midwives………………………………….………..……………………1,990
Advanced Practice Nurse Prescribers ……………………..………………………..……….303 Chiropractors…………………………………………………….………………..…………...346
Dentists………………………………………………………………………..………………..173
Oral Surgeons…………………………………………………….………..………………..1,298
Podiatrists-Surgical………………………………………………..……………..…………3,678
Optometrists…………………………………………………………..……………..………….173
Physician Assistants…………………………………………………..……..………………..173
(m) For a corporation organized under ch. 181, Stats., for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees: 1. a. If the total number of employed physicians and nurse anesthetists is from 1 to 10……………………………………………………………..……………………………….$ 30
b. If the total number of employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………………...$ 299
c. If the total number of employed physicians or nurse anesthetists exceeds 100………………………………………………………………………………………..……….$ 744
2. The following fee for each full-time equivalent allied health care professional employed by the corporation as of the most recent completed survey submitted:
Employed Health Care Professionals Fund Fee
Nurse Practitioners ……………………………………………………………….……….$ 216
Advanced Nurse Practitioners…………………………………………………….……….…303
Nurse Midwives…………………………………………………………………………....…1,903
Advanced Nurse Midwives…………………………………………………………….……1,990
Advanced Practice Nurse Prescribers …………………………………………………….…..303
Chiropractors………………………………………………………………………………..…...346
Dentists……………………………………………………………………..………………..…..173
Oral Surgeons……………………………………………………………….………..…..…..1,298
Podiatrists-Surgical…………………………………………………..…….….………..……3,678
Optometrists…………………………………………………………………………….……….173
Physician Assistants …………………………………………………………………………..173
(n) For an operational cooperative sickness care plan as described under s. 655.002 (1) (f), Stats., all of the following fees: 1. Per 100 outpatient visits during the last calendar year for which totals are available…………………………………………………………………………….………………$0.07
2. 2.5% of the total annual fees assessed against all of the employed physicians.
3. The following fee for each full-time equivalent allied health care professional employed by the operational cooperative sickness plan as of the most recent completed survey submitted:
Employed Health Care Professionals Fund Fee
Nurse Practitioners…………………………………………………………………..…….$ 216
Advanced Nurse Practitioners…………………………………………………………….…303
Nurse Midwives………………………………………………………………………..…….1,903
Advanced Nurse Midwives…………………………………………………..…………….1,990
Advanced Practice Nurse Prescribers ………………………………………..……………..303
Chiropractors……………………………………………………………………..……….…...346
Dentists……………………………………………………………………………………..…..173
Oral Surgeons………………………………………………………………………..….…..1,298
Podiatrists-Surgical………………………………………………………………..……..…3,678
Optometrists………………………………………………………………………….…..…….173
Physician Assistants……………………………………………………….…………..……..173
(o) For a freestanding ambulatory surgery center, as defined in s. DHS 120.03 (13), per 100 outpatient visits during the last calendar year for which totals are available:………………………………………………………………………………………….$13.50 (p) For an entity affiliated with a hospital, the greater of $100 or whichever of the following applies:
1. 7.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has occurrence coverage.
2. 10.0% of the amount the entity pays as premium for its primary health care liability insurance, if it has claims-made coverage.
(q) For an organization or enterprise not specified as a partnership or corporation that is organized and operated in this state for the primary purpose of providing the medical services of physicians or nurse anesthetists, all of the following fees:
1. a. If the total number of employed physicians and nurse anesthetists is from 1 to 10………………………………………………………………………………...………………$ 30
b. If the total number of employed physicians and nurse anesthetists is from 11 to 100……………………………………………………………………………………………...$ 299
c. If the total number of employed physicians or nurse anesthetists exceeds
100………………………………………………………………………………………………$ 744
2. The following for each full-time equivalent allied health care professional employed by the organization or enterprise not specified as a partnership, corporation, or an operational cooperative health care plan as of the most recent completed survey submitted:
Employed Health Care Professionals Fund Fee
