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NEWSLINE
Release Number: 2020-97
November 18, 2020

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

On October 7, the Division of Workers’ Compensation’s Administrative Director issued an order adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers Fee Schedule portion of the Official Medical Fee Schedule to conform to changes in the Medicare system, effective for services rendered on or after October 1, 2020.

Subsequently, on October 21, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a corrected Addendum A and corrected Addendum B to supersede the previous documents.

The Administrative Director has issued an order dated November 5, 2020, to adopt CMS’ corrected Addendum A and Addendum B for Hospital Outpatient Departments/Ambulatory Surgical Centers services rendered on or after October 1, 2020. The order makes the following changes:

  • Incorporates by reference CMS’ HOPPS addendum A found in the October 2020 CORRECTION Addendum A (ZIP) – updated 10/21/2020 file, in place of the original file, for services rendered on or after October 1, 2020
  • Incorporates by reference CMS’ HOPPS addendum B found in the October 2020 CORRECTION Addendum B (ZIP) – updated 10/21/2020 file, in place of the original file, for services rendered on or after October 1, 2020
  • Corrects a clerical error in the reference to the Integrated Outpatient Code Editor provisions relating to Comprehensive APC (J1 and J2) Status Indicator.

The Administrative Director update order dated October 7, 2020 remains in effect for services rendered on or after October 1, 2020, except as modified by Administrative Director order dated November 5, 2020. The Orders and regulations can be found at the DWC OMFS web page.