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NEWSLINE
Release Number: 2021-30
March 23, 2021

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 April 1, 2021 second quarter changes and the revised telehealth list:

  • CMS’ Medicare National Physician Fee Schedule Relative Value File RVU21B (Updated 03/02/2021) (ZIP) April 1, 2021 quarterly update
  • National Correct Coding Initiative Practitioner Procedure to Procedure (PTP) Edits April 1, 2021 quarterly update
  • National Correct Coding Initiative Medically Unlikely Edits April 1, 2021 quarterly update (excluding MUE “0” value codes)
  • CMS’ ZIP Code to Carrier Locality files April 1, 2021 quarterly update, for Geographic Practice Cost Index (GPCI) locality mapping
  • List of Telehealth Services for Calendar Year 2021 (ZIP) – Updated 03/09/2021

The above OMFS adjustments are effective for services rendered on or after April 1, 2021.

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