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April 3, 2024
California Division of Workers' Compensation Posts Adjustments to Official Medical Fee Schedule (DMEPOS)

The California Division of Workers’ Compensation (DWC) has received inquiries regarding an update to the Official Medical Fee Schedule (OMFS).

The Physician and Non-Physician Practitioner Fee Schedule based on the federal Resource Based Relative Value Scale (RBRVS) was adopted pursuant to the requirements of Senate Bill 863 and became effective for services rendered on or after January 1, 2014.

The Medicare final physician fee schedule RBRVS rule for 2015 was published in the Federal Register on November 13with an effective date of January 1, 2015. The Labor Code requires that the fee schedule be updated within 60 days after the effective date of the Medicare revision by issuance of an Administrative Director update order. DWC has been working diligently to complete review of the rule and Relative Value File and to determine the updates that are needed.

As a result of review of the published final rule, and based on prior Medicare practice, DWC anticipates that the Centers for Medicare & Medicaid Services (CMS) will be posting a Physician Fee Schedule Final Rule Correction Notice. DWC has determined that it would be most efficient to wait for the Medicare Final Rule Correction Notice before adopting an update. After publication of the Medicare Final Rule Correction Notice, DWC will review the revisions, and will issue an Administrative Director update order making appropriate adjustments to the workers’ compensation fee schedule.

The Administrative Director update order will specify the effective date of the changes. If the Medicare correction notice is issued prior to the end of December, DWC anticipates that the 2015 update to the Physician and Non-Physician Practitioner Fee Schedule will be effective for services rendered in early February 2015. The estimated date is subject to change depending on the date of issuance of the Medicare Final Rule Correction Notice, the extent of the changes, and the need to allow time for implementation by providers and payers.

You may receive the announcement of the 2015 fee schedule update by subscribing to DWC’s Newsline mailing list. Upon adoption, the 2015 fee schedule will be posted to the DWC website. 

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California Department of Industrial Relations, P.O. Box 420603 · San Francisco, CA · 94142-0603 · www.dir.ca.gov