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 October 4, 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. Thereafter, DWC issued an order dated October 21, 2022 adopting the Centers for Medicare and Medicaid Services’ (CMS’) revised fee schedule documents dated October 18, 2022. Subsequently, the CMS issued revised fee schedule documents dated November 14, 2022.

This Order adopts and incorporates by reference CMS’ HOPPS Addendum A-updated 11/14/2022 and Addendum B-updated 11/14/2022, in place of the previous files, for services rendered on or after October 1, 2022. CMS erroneously left out APC 9017 from Addendum A and HCPCS code Q5124 from Addendum B from the prior file and added it back in the 11/14/2022 corrections.

The Administrative Director update order dated October 4, 2022 and supplemental order dated October 21, 2022 remain in effect for services rendered on or after October 1, 2022, except as modified by Administrative Director order dated November 21, 2022.

The order adopting the OMFS adjustments is effective for services rendered on or after October 1, 2022 and is posted on the DWC website.

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