DWC Posts Additional Adjustments to Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)
The Administrative Director of the Division of Workers’ Compensation (DWC) issued an order dated February 8, 2022 adopting the annual update to the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to the Medicare payment system as required by Labor Code section 5307.1. Subsequently, on February 10, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a revised ASC Approved HCPCS Code and Payment Rates file, updated February 10, 2022.
The order adopts specified columns of certain tables of the CMS January 2022 ASC Approved HCPCS Code and Payment Rates file updated on February 10, 2022, which replaces the file dated January 14, 2022, for services rendered on or after March 1, 2022. The specified columns of the tables are components used in defining the scope of “surgical procedures” for fee schedule purposes. The order also adopts and identifies additional CPT codes in defining the scope of “surgical procedures.”
The Administrative Director update order dated February 8, 2022 remains in effect for services rendered on or after March 1, 2022, except as modified by Administrative Director order dated February 15, 2022. The orders and regulations can be found at the DWC website’s OMFS page.