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 changes:

• CMS Medicare National Physician Fee Schedule Relative Value File RVU19B April 1, 2019 quarterly update
• National Correct Coding Initiative Physician/Practitioner Services CCI Edits April 1, 2019 quarterly update
• National Correct Coding Initiative Medically Unlikely Edits April 1, 2019 quarterly update (excluding MUE “0” value codes)

The updated regulation text includes the March 15 monthly Medi-Cal Rates file update for physician-administered drugs, biologicals, vaccines or blood products as well as the April 1, 2019 quarterly updates.

The order adopting the quarterly OMFS adjustments is effective for services rendered on or after April 1, 2019 and can be found on the DWC website.

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