DWC Posts Adjustments to Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to changes in the Medicare payment system as required by Labor Code section 5307.1.
The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Center for Medicare & Medicaid Services (CMS) Medicare changes:

April 2024 Quarterly Update

• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) April 2024 Addendum A-updated 03/26/2024
• The CMS Medicare OPPS April 2024 Addendum B-updated 03/26/2024
• The CMS Ambulatory Surgical Center Payment System, April 2024 ASC Approved HCPCS Code and Payment Rates Column A entitled “HCPCS Code” of “Apr 2024 ASC AA” and Column A entitled “HCPCS Code” of “Apr 2024 ASC EE”
• Certain sections of the CMS Medicare OPPS April 2024 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V251.R0

The order also adopts a corrected Section 9789.35 Table B to remove 4 ambulatory surgical centers that were inadvertently included on the list of hospital outpatient departments.

The order adopting the OMFS adjustments is effective for services rendered on or after April 1, 2024 and is posted on the DWC website’s OMFS page.

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