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| | DWC Posts Additional Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services)
By News Release, California Department of Industrial Relations - April 4, 2016
The CA DIR Division of Workers’ Compensation (DWC) has posted an order adjusting the Physician Services/Non-Physician Practitioner Services section of the Official Medical Fee Schedule (OMFS) to conform to relevant 2016 changes in the Medicare payment system as required by Labor Code section 5307.1.
The Physician and Non-Physician Practitioner Fee Schedule update Order adopts the following changes for services rendered on or after April 1, 2016:
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Medicare issued a correction notice published on March 8, 2016. The Medicare notice corrects the 2016 Relative Value Unit (RVU) budget neutrality adjustment factors and are adopted as follows:
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2016 RVU budget neutrality adjustment factor for anesthesia, surgery, radiation, and all other services: 0.99924
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2016 Anesthesia Practice Expense and Malpractice adjustment factor: 0.97628
Applying the above adjustment factors, the OMFS Physician Services/Non-Physician Practitioner services Conversion Factors adjusted for MEI and Relative Value Scale adjustment factors are updated and adopted as follows:
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Anesthesia
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28.8003
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Surgery
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48.1743
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Radiology
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47.4332
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All other services
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42.4361
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Medicare quarterly file updates are adopted as follows:
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The April 1, 2016 quarterly update to the Practitioner Services Medically Unlikely Edits
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The April 1, 2016 CMS’ Medicare quarterly update to the National Correct Coding Initiative Practitioner PTP Edits
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The April 1, 2016 quarterly update to the Medicare National Physician Fee Schedule Relative Value File (RVU file) RVU16B
The revisions are set forth in section 9789.19 subdivision (c) of Title 8 California Code of Regulations.
The acting administrative director update orders adopting the OMFS adjustments effective for services rendered on or after April 1, 2016, can be found on the DWC website.
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California Department of Industrial Relations, Division of Workers' Compensation, www.dir.ca.gov
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