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Release Number: 2021-102
Date: October 11, 2021

DWC Posts Additional Adjustment 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.

On September 20, 2021, the DWC Administrative Director issued an order adjusting the OMFS Physician and Non-Physician Practitioner Fee Schedule to adopt relevant Medicare physician fee schedule changes for Quarter 4 of 2021. Subsequently, on October 5, 2021, the Centers for Medicare and Medicaid Services (CMS) issued revised files for the Quarter 4 National Correct Coding Initiative’s Practitioner PTP Edits. The additional DWC update order adopts the revised Practitioner PTP Edits to supersede the previous file for services rendered on or after October 1, 2021. The other provisions of the September 20, 2021 update order have not been revised and remain in effect.

The order adopting the above OMFS adjustment is posted on the physician services and non-physician practitioner services fee schedule webpage.