DWC Posts Additional Adjustments to Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)

The Administrative Director of the Division of Workers' Compensation (DWC) issued an Order dated April 1, 2024, adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to the quarterly changes in the Medicare payment system as required by Labor Code section 5307.1. Subsequently, the Centers for Medicare and Medicaid Services (CMS) issued revised fee schedule documents for the April quarter update.

DWC has posted an order adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule to adopt the following Medicare updates:

April Quarter Update

• The CMS Ambulatory Surgical Center Payment System, April 2024 ASC Approved HCPCS Code and Payment Rates-Updated 03/29/2024, Column A entitled "HCPCS Code" of "Apr 2024 ASC AA" and Column A entitled "HCPCS Code" of "Apr 2024 ASC EE."
• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) Addendum A April 2024-updated 04/23/2024.
• The CMS Medicare OPPS Addendum B April 2024-updated 04/23/2024.

The updated order dated May 7, 2024 adopting the OMFS adjustments is effective for services rendered on or after April 1, 2024 and is posted on the DWC website's OMFS page.

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