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:

October 2020 Quarterly Update:

• CMS’ Medicare National Physician Fee Schedule Relative Value File RVU20D October 1, 2020 quarterly update
  
• National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits October 1, 2020 quarterly update
  
• National Correct Coding Initiative Medically Unlikely Edits October 1, 2020 quarterly update (excluding MUE “0” value codes)
  
• CMS’ ZIP Code to Carrier Locality files October 1, 2020 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping

The above OMFS adjustments are effective for services rendered on or after October 1, 2020.

The order adopting the above OMFS adjustments can be found on the physician services and non-physician practitioner services fee schedule webpage.

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