DWC Posts Additional Adjustments to Official Medical Fee Schedule for Pathology and Clinical Laboratory

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS) to conform to relevant 2021 changes in the Medicare payment system as required by Labor Code section 5307.1.

The order adopts the Medicare April 2021 quarterly update to the Pathology and Clinical Laboratory Fee Schedule. In addition, the order adopts prices for specified COVID-19 testing codes based upon 120% of the price established by the California Medicare Administrative Contractor. The order lists COVID-19 testing codes previously adopted for dates of service as specified, as well as additional COVID-19 codes that are effective for services on or after April 1, 2021.

The Administrative Director’s update order dated March 30, 2021 adopting the OMFS adjustment is effective for services rendered on or after April 1, 2021, except where an earlier date is specified. The order can be found on the website of the Division of Workers’ Compensation on the Pathology and Clinical Laboratory webpage.

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