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Release Number: 2019-79
October 22, 2019

DWC Posts Additional 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/Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to relevant changes in the Medicare payment system as required by Labor Code section 5307.1. The order is for services rendered on or after October 1, 2019 and adopts the following changes:

  • Adopts the Centers for Medicare and Medicaid Services (CMS) September 29, 2019 corrected Addendum A of the “Addendum A - Correction” file, and Addendum B of the “Addendum B - Correction” file.
  • Adopts certain columns of the Centers for Medicare and Medicaid Services (CMS) corrected addenda AA and EE of the “October 2019 ASC Approved HCPCS Code and Payment Rates CORRECTIONS - Updated 10/15/2019” file, which provides a partial list of surgical codes payable under the hospital outpatient fee schedule. (This is a technical revision; the updated file makes no changes to the list of surgical codes.)

The Administrative Director update order dated September 25, 2019 remains in effect for services rendered on or after October 1, 2019, except as modified by the Administrative Director order dated October 17, 2019.

The orders and regulations can be found at the DWC website’s OMFS page.