DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services)

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.
The Physician and Non-Physician Practitioner Fee Schedule update Order adopts the following Medicare July 1, 2021 third quarter changes:

• CMS’ Medicare National Physician Fee Schedule Relative Value File July 1, 2021 quarterly update - RVU21C
• National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits July 1, 2021 quarterly update
• National Correct Coding Initiative Medically Unlikely Edits July 1, 2021 quarterly update (excluding MUE “0” value codes)
• CMS’ ZIP Code to Carrier Locality files July 1, 2021 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping

The above OMFS adjustments are effective for services rendered on or after July 1, 2021.

The order adopting the above OMFS adjustments is posted on the physician services and non-physician practitioner services fee schedule webpage.

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