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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 adopted and filed an amendment to the official medical fee schedule (OMFS) hospital outpatient departments and ambulatory surgical centers (HOPD/ASC) section with the Secretary of State.

The amended regulation institutes a payment model where the maximum allowances for all hospital outpatient department services that are payable under the Medicare hospital outpatient departments prospective payment system (HOPPS), including “Other Services,” be determined based on the Medicare HOPPS; expands the definition of surgical procedure HCPCS codes to align with Medicare’s HOPPS surgical procedures; and adjusts the fee schedule to conform to relevant changes in the Medicare HOPPS for calendar years 2015 and 2016.

The regulation amends title 8, California Code of Regulations sections, and is effective December 15, 2016. The regulation can be found on the DWC website.

Further information and adjustments to the HOPD/ASC section of the OMFS can be found on the DWC’s OMFS web page. 

lonce@adjustercom.com; Lonce LaMon, journalist; written from the News Release of the California Department of Industrial Relations, dated December 16th 2016