DWC posts adjustments to the Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)

The Administrative Director of 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 the CY2026 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 Centers for Medicare & Medicaid Services (CMS) Medicare changes:

• New status indicator code “S1” for skin substitutes and APC payment rate of $127.14 per square centimeter
• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) January 2026 Addendum A
• The CMS Medicare Hospital OPPS January 2026 Addendum B
• The CMS Ambulatory Surgical Center Payment System, January 2026 ASC Approved HCPCS Code and Payment Rates-Updated 02/11/2026, Column A entitled “HCPCS Code” of “January 2026 ASC AA” and Column A entitled “HCPCS Code” of “January 2026 ASC EE.”

The order adopting the OMFS adjustments is effective for services rendered on or after March 1, 2026 and is posted on the DWC website’s OMFS page.

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