DWC Posts Adjustments to Official Medical Fee Schedule for Physician and Non-Physician Practitioner Services

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Physician and Non-Physician Practitioner Services 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 Administrative Director update order adopting the OMFS adjustments is effective for services rendered on or after February 15, 2023. The adjustments include the following:

• Updated relative value units
• Updated Current Procedural Terminology coding
• Updated conversion factors (including Medicare relative value scale adjustments; Medicare Economic Index 3.8% inflation factor; Consolidated Appropriations Act, 2023, 2.5% increase)
• Updated Table A – anesthesia conversion factors adjusted for Geographic Practice Cost Index
• Updated telehealth list

Providers and claims administrators should be aware that the 2023 CPT evaluation and management codes, including codes for hospital inpatient and observation care, emergency department services and nursing facility services, have been substantially reorganized and revised. The criteria for selecting levels of service have been revised and parallel the CPT changes for office/outpatient evaluation and management coding that were previously adopted.

The order, effective for services rendered on or after February 15, 2023, and related documents can be found at the DWC OMFS physician fee schedule webpage.

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