Bulletin No. 14-04
April 6, 2004

DWC posts list of facilities using "high cost outlier" payment methodology

DWC has posted the list of hospital outpatient departments and ambulatory surgery centers who have opted for the alternate "high cost outlier" payment methodology under the Official Medical Fee Schedule (OMFS). These facilities, rather than being paid at 1.22 times the Medicare rate on all cases, are paid at 1.20 times the Medicare rate on all cases plus an additional payment for specific outlier cases. Only these facilities are entitled to be paid using the alternate method under Labor Code section 9789.33 (b).

The list can be found online at http://www.dir.ca.gov/IMC/costchrg.html.