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 2024 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, 2024. The adjustments include the following.

• Updated relative value units
• Updated Current Procedural Terminology coding
• Updated conversion factors (including consideration of Medicare relative value scale adjustments; Medicare Economic Index 4.6% inflation factor; relevant provisions of the Consolidated Appropriations Act, 2023)
• Updated National Correct Coding Initiative Edits
• Updated Table A – anesthesia conversion factors adjusted for Geographic Practice Cost Index localities
• Revision of Place of Service codes related to telehealth
• Updated telehealth list

Providers and claims administrators should be aware that the Medicare Localities in California have been revised from 32 localities to 29 localities. Locality numbers 06, 07, and 26 have been eliminated and merged into other localities. The Medicare Physician Fee Schedule Final Rule indicates that the locality revisions will not change reimbursement levels within the affected localities.

The order, effective for services rendered on or after February 15, 2024, and related documents can be found at the DWC OMFS physician fee schedule webpage.

---