DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services / Non-Physician Practitioner Services)

The Division of Workers’ Compensation (DWC) has posted an order adjusting the Official Medical Fee Schedule (OMFS) to conform to 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 Medicare April 1, 2024, 2nd quarter changes:

• CMS’ Medicare National Physician Fee Schedule Relative Value File quarterly update - RVU24B effective April 1, 2024,
• CMS’ Zip Code to Carrier Locality files effective April 1, 2024, quarterly update for locality mapping
• Updated Practitioner Procedure to Procedure (PTP) Edits
• Updated Medically Unlikely Edits

The Order also adopts increases to the conversion factors for Anesthesia and Services Other Than Anesthesia to implement relevant Medicare Physician Fee Schedule provisions of the Consolidated Appropriations Act, 2024. For anesthesia services DWC has posted a revised Table A which sets forth the geographic-adjusted conversion factor for each California locality.

The above OMFS adjustments are effective for services rendered on or after April 1, 2024.

The order adopting the above OMFS adjustments is posted on the physician services and non-physician practitioner services fee schedule webpage.

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