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

The Division of Workers’ Compensation (DWC) posted an order on September 23, 2021 adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to the quarterly changes in the Medicare payment system as required by Labor Code section 5307.1. Subsequently, the Centers for Medicare and Medicaid Services (CMS) issued an October 2021 ASC Approved HCPCS Code and Payment Rates file, updated September 23, 2021. CMS also issued a corrected Addendum A and Addendum B to supersede the previous documents, effective October 1, 2021.

The Order adopts specified columns of certain tables of the CMS October 2021 ASC Approved HCPCS Code and Payment Rates file updated on September 23, 2021, which replaces the file dated September 22, 2021, for services rendered on or after October 1, 2021. The Order adopts and incorporates by reference CMS’ HOPPS Addendum A-CORRECTION and Addendum B-CORRECTION, in place of the original files, for services rendered on or after October 1, 2021.

The Administrative Director update order adopting the OMFS adjustment is effective for services rendered on or after October 1, 2021, and can be found at the DWC website’s OMFS page

---