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 RVU20B April 1, 2020 quarterly update
• National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits April 1, 2020 quarterly update
• National Correct Coding Initiative Medically Unlikely Edits April 1, 2020 quarterly update (excluding MUE “0” value codes)
• CMS’ ZIP Code to Carrier Locality files April 1, 2020 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping

The order adopting the OMFS adjustments is effective for services rendered on or after April 1, 2020 and can be found on the DWC website.

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