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Release Number: 2022-106
Date: December 20, 2022

DWC Posts Additional Adjustments to Official Medical Fee Schedule Inpatient Hospital Section to Conform to Medicare Changes

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Inpatient Hospital section of the Official Medical Fee Schedule (OMFS) to conform to relevant 2023 changes in the Medicare payment system as required by Labor Code section 5307.1.

The order is the second Administrative Director order for the 2023 annual update to the Inpatient Hospital Fee Schedule, for discharges on or after December 1, 2022. The Centers for Medicare and Medicaid Services (CMS) published a Correcting Amendment on November 4, 2022 in the Federal Register, and corrected the FY 23 Impact File. On December 13, 2022 CMS published a Correction Notice correcting typographical errors in the final rule and in the November 4, 2022 corrections. The Administrative Director order amends title 8, California Code of Regulations, sections 9789.23, 9789.24, and 9789.25 to adopt changes that conform to the corrections made by Medicare, effective for discharges on or after December 1, 2022. The amended table (sections 9789.23) with revised Hospital Specific Outlier factors supersedes the original table.

The order also corrects a clerical error in the reference to Title 42, Code of Federal Regulations, Section 412.106.

The Administrative Director order dated October 31, 2022 remains in effect for discharges on or after December 1, 2022, except as modified by the Administrative Director order dated December 19, 2022.

The order and regulations and can be found at the DWC website’s OMFS page.