CA DWC Posts Adjustments to Official Medical Fee Schedule (DMEPOS) By CA Department of Industrial Relations - December 17, 2015
The California Division of Workers’ Compensation (DWC) has posted an order adjusting the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) section of the Official Medical Fee Schedule to conform to the 2016 changes in the Medicare payment system as required by Labor Code section 5307.1. The update includes all changes identified in Center for Medicare and Medicaid Services Change Request (CR) number 9431.
The public should take note that for calendar year 2016, the data files contain a new structure which includes “California Non-Rural” and “California Rural” fee columns. For some codes, the fee for services in a rural area is different from the fee in a non-rural area. The status of “non-rural” versus “rural” is determined using the injured worker’s address and the Medicare ZIP code file included in the adopted DME16-A fee schedule.
The order effective for services on or after January 1, 2016, adopts the Medicare DMEPOS first release for calendar year 2016.
The order adopting the adjustment can be found on the DWC website.
California Department of Industrial Relations * www.ca.dir.gov
Adjuster / Examiner Claims Examiner Santa Ana Unified School District Santa Ana, CA