DWC updates hospital outpatient department and ambulatory surgical center fee schedule to reflect additional July 2026 Medicare changes

The Division of Workers’ Compensation (DWC) has posted an administrative order updating the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to additional July 2026 Medicare payment system changes, as required by Labor Code section 5307.1.

The order adopts the Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System Addenda A and B, both updated July 21, 2026, replacing the previous files. The updated files apply to services rendered on or after July 1, 2026. 

The administrative orders dated July 3 and July 15, 2026, remain in effect for services rendered on or after July 1, 2026, except as modified by the August 3, 2026, administrative order.

The August 3 order is effective for services rendered on or after July 1, 2026, and is posted on DWC’s OMFS webpage.

The California Department of Industrial Relations’ Division of Workers’ Compensation monitors the administration of workers’ compensation claims and provides administrative and judicial services to help resolve disputes related to claims for workers’ compensation benefits

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