DWC Posts Adjustments to Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.

The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Centers for Medicare & Medicaid Services (CMS) Medicare changes:

• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) April 2019 Addendum A quarterly update
• The CMS Medicare OPPS April 2019 Addendum B quarterly update
• The CMS Ambulatory Surgical Center Payment System, April 2019 ASC Approved HCPCS Code and Payment Rates, Column A entitled “HCPCS Code” of “Apr 2019 ASC AA” and Column A entitled “HCPCS Code” of “Apr 2019 ASC EE”
• Certain sections of the CMS Medicare OPPS April 2019 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V20.1 quarterly update
• CMS April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS), Change Request (CR) 11216 (March 15, 2019), Transmittal R4255CP

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

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