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Release Number: 2020-47
May 27, 2020

DWC Posts Additional Adjustments to Official Medical Fee Schedule for Pathology and Clinical Laboratory (Additional COVID-19 Codes/Fees Added)

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS) to conform to additional Medicare updates to COVID-19 testing codes and fees as required by Labor Code section 5307.1.

On May 19, 2020, the Centers for Medicare and Medicaid Services published fees for three additional COVID-19 testing codes. The Administrative Director update order dated May 21, 2020 adopts additional codes and fees to supplement the COVID-19 testing codes and fees adopted by the Order dated April 15, 2020. The OMFS adjustment adopts fees retroactively to the Medicare effective dates as follows: CPT Code 87635 (infectious agent detection by nucleic acid tests) - effective for services on or after March 13, 2020, CPT codes 86769 and 86328 (for antibody tests) - effective for services on or after April 10, 2020.

The Administrative Director update Order can be found at the DWC OMFS Pathology and Laboratory Fee Schedule webpage.