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 on June 30, 2022, adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to the quarterly changes in the Medicare payment system as required by Labor Code section 5307.1. Subsequently, the Centers for Medicare and Medicaid Services (CMS) issued revised fee schedule documents dated July 12, 2022.

DWC has posted an Order to adopt specified columns of certain tables of the CMS July 2022 ASC Approved HCPCS Code and Payment Rates file updated on July 12, 2022, which replaces the file dated June 30, 2022, to define “surgical codes,” for services rendered on or after July 1, 2022. The revision makes no changes to the HCPCS codes listed in column A of addendum AA and column A of addendum EE.

The Administrative Director update order dated June 30, 2022, remains in effect for services rendered on or after July 1, 2022, except as modified by the Administrative Director order dated July 20, 2022. The orders and regulations can be found on the DWC website’s OMFS page.

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