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 December 23, 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 calendar year 2022. Subsequently, on January 5, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a revised Telehealth List. The additional DWC update order adopts the revised Telehealth List to supersede the previous file for services rendered on or after January 1, 2022. The updated Telehealth List adopts three codes changes: adopts new CPT codes 94625 and CPT 94626 (relating to professional services for outpatient pulmonary rehabilitation), and deletes HCPCS code G0424 (relating to pulmonary rehabilitation with exercise.)
The other provisions of the December 23, 2021 calendar year 2022 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.