Where to Send Medical Treatment Guideline Variance Requests

Medical Providers should submit their Medical Treatment Guideline (MTG) Variance Requests, forms MG-2 and MG-2.1, to NYSIF business office MTG teams. Reference your respective NYSIF business office MTG shared e-mail, MTG shared fax and claim unit numbers provided below:

NYSIF Medical Treatment Guideline (MTG) Nurse Teams
Office MTG Shared E-mail Box MTG Shared Fax Claim Units
BRONX
QUEENS (BQ)
mtg-brxqueens@nysif.com (212) 312-7470 24, 28, 29, 368, 369, 370, 371, 372, 373, 374, 381
BROOKLYN/STATEN ISLAND (B-SI) mtg-bklynsi@nysif.com (212) 312-7938 20, 301, 302, 303, 304, 305, 306, 307, 308, 311
LOWER MANHATTAN (LM) mtg-lowerman@nysif.com (212)-587-9294 321, 322, 323, 324, 325, 326, 327, 328, 329, 331
UPPER MANHATTAN (UM) mtg-upperman@nysif.com (212) 587-9295 50, 52, 53, 54, 57, 58, 59, 150, 361, 362, 363, 364, 365, 367
NASSAU mtg-nassau@nysif.com (631) 756-4206 100, 102, 104, 105, 106, 107, 108, 109, 110, 111, 113, 114, 116, 117, 118, 119, 121, 122, 123, 124, 125, 126, 127, 129, 141, 142, 199
SUFFOLK mtg-suffolk@nysif.com (631) 756-4272 55, 217, 235, 236, 237, 238, 239, 240, 241, 242, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253, 254, 255, 256, 257, 260, 261, 262, 263
WHITE PLAINS mtg-whiteplains@nysif.com
(914) 701-2188 153, 157, 164, 165, 171, 172, 174, 190, 191, 215
ALBANY mtg-albany@nysif.com (518) 437-8997 25, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 180, 181, 182, 183, 184, 185, 212
BUFFALO mtg-buffalo@nysif.com (716) 851-2096 80, 81, 82, 83, 84, 85, 89, 140, 146, 202, 205, 206, 207, 208, 209, 218
ROCHESTER mtg-rochester@nysif.com (585) 258-2004 70, 71, 72, 74, 77, 79, 216
SYRACUSE mtg-syracuse@nysif.com
(315) 453-8337 60, 61, 62, 63, 66, 67, 130, 131, 132, 133, 138, 139, 214
BINGHAMTON mtg-binghamton@nysif.com
(607) 741-5605 281, 282, 283, 284, 285, 286, 287, 288, 289

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