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

The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Centers for Medicare & Medicaid Services (CMS) Medicare changes: 

• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) October 2019 Addendum A quarterly update
• The CMS Medicare OPPS October 2019 Addendum B quarterly update
• The CMS Ambulatory Surgical Center Payment System, October 2019 ASC Approved HCPCS Code and Payment Rates, Column A entitled “HCPCS Code” of “Oct 2019 ASC AA” and Column A entitled “HCPCS Code” of “Oct 2019 ASC EE”
• Certain sections of the CMS Medicare OPPS October 2019 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V20.3 quarterly update
• CMS October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS), Change Request (CR) 11451 (August 30, 2019), Transmittal R4387CP

The order adopting the OMFS adjustments is effective for services rendered on or after October 1, 2019, and can be found on DWC’s website.

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 lonce@adjustercom.com, Lonce Lamonte, journalist and editor, with the DWC Newsline release of October 4th 2019.