What Is a Medical Provider Network (MPN)?

If you've been told "you have to choose a doctor from the MPN," and you don't know what that means, you're not alone. The Medical Provider Network is one of the most misunderstood parts of the workers' compensation system. Here's what it is, why it exists, and what you can do when it gets in your way.

What an MPN actually is

A Medical Provider Network is a roster of doctors that your employer's workers' compensation insurance carrier (or your self-insured employer) has contracted to treat work-related injuries. The MPN is administered by a third party — usually a TPA (third-party administrator) like Sedgwick, CorVel, or Coventry — that handles the network's day-to-day operations.

Each MPN has:

• A name and ID number (e.g. "Sedgwick CMS Extended MPN, MPN ID 2479").
• A roster of contracted providers, organized by state, specialty, and city. Updated periodically (every few months for most networks).
• Access standards — the network must provide enough providers within reasonable distance of every covered worker (typically 15 miles for primary care, 30 miles for specialties).
• Utilization review — a process by which the network reviews treatment requests and either authorizes or denies coverage.

Why MPNs exist

Before MPNs (in states like California), employers had limited control over which doctors treated injured workers. The result was a system in which "treating physician" sometimes meant "doctor with no WC experience who charged twice the fee schedule." MPNs were created to:

• Channel injured workers to providers with WC experience.
• Give carriers rate predictability through pre-negotiated fee schedules.
• Speed claim resolution by reducing variability in treatment decisions.

That's the theory. In practice, MPNs sometimes channel workers toward provider mills with high throughput and low individual attention. Whether your MPN works well depends heavily on which one your employer uses.

The states with formal MPN systems

Not every state uses MPNs. The most formalized systems are in:

• California — the original and most regulated MPN system. Approved networks are listed on the DWC's public site; access standards are enforced; you have specific change-of-physician rights.
• Texas — "Health Care Network" (HCN) is the local term, but the structure is similar.
• New York — Preferred Provider Organizations (PPOs) are used in some claims.
• Florida — managed care arrangements via carrier-designated providers.

Other states use employer-choice or employee-choice models instead. See our provider-choice guide for the state-by-state breakdown.

How to verify an MPN provider

MPN rosters change. A provider listed today may exit the network next week. Three layers of verification:

1. The MPN's official lookup tool. Most MPNs publish a search tool (e.g. Sedgwick uses sedgwickproviders.com). Check current participation here first.
2. The practice itself. Call the front desk and ask: "Are you currently in [MPN name]?" Have them check their contracted-networks list. If they hesitate or confirm without checking, that's a red flag.
3. Your claims adjuster. Email or call to confirm the provider is in-network before the appointment. Get the confirmation in writing.

Our directory's network hubs list our most recent data on each major MPN, but always cross- check with the MPN's official tool before booking.

What to do if the MPN doesn't have what you need

MPNs are required to provide reasonable access to care across every specialty needed for WC claims. If your MPN doesn't have a provider you need:

• The needed specialty isn't covered: the MPN must authorize an out-of-network referral. Document the gap and request the referral in writing.
• The nearest provider is too far: California requires WC providers within 15 miles for primary care and 30 miles for specialty care. If your network violates these standards, you can file an access complaint with the DWC.
• The available providers aren't accepting new patients: document this with specific dates (provider, phone call, response). The MPN is responsible for ensuring access, not just listing names on a roster.

Common questions

Can I see a provider outside the MPN?

Usually no, unless the MPN authorizes an out-of-network referral (because the needed specialty isn't covered or access standards can't be met). Going outside without authorization means the carrier may deny payment for the visit.

Does my employer choose the MPN?

Yes, in most cases. The employer or their carrier picks the MPN at policy inception. You don't have a say. You can, however, change providers within the MPN.

What if I'm not happy with any of the MPN providers in my city?

After the mandatory waiting period (usually 30 days in California), you can typically switch to any other provider within the MPN — no approval needed for the first switch. Subsequent switches may require justification. After longer windows (often 90 days), you may be able to go outside the MPN entirely.

How often does an MPN update its roster?

Most MPNs publish a refreshed roster every quarter, with rolling updates as providers join or leave the network. State law often requires the public roster to be updated within 30 days of a provider change. In practice, the lag is often longer.

The bottom line

An MPN is the list of doctors your workers' comp insurance will pay to treat your injury. It's a constraint, but not an absolute one — there are change-of-physician rights, access standards, and out-of-network referral processes that let you navigate around a bad fit. The most important move on day one is to know which MPN you're in and what its rules are.

Ready to look up your MPN? Browse our network hubs — we cover the major WC MPNs with city-level breakdowns of their participating providers.