1. DWC

Workers' compensation pharmacy fee schedule - Simple prescription – for prescriptions dispensed prior to 7/1/2025

NOTICE: A revised pharmaceutical fee schedule has been adopted and will become effective for drugs dispensed on or after July 1, 2025. The February 20, 2019 data file will remain in effect for pharmaceuticals dispensed prior to the July 1, 2025 effective date of the new Pharmaceutical Fee Schedule. Details of the revisions may be reviewed on the DWC Approved Regulations webpage. Further information regarding the new fee schedule and sample data files can be accessed on the new fee schedule webpage. The calculator set forth on this page will continue to be available for determining maximum fees for pharmaceuticals dispensed prior to 7/1/2025. Notices relating to the Pharmaceutical Fee Schedule will be sent to the DWC Newsline mailing list. You may subscribe to the DWC Newsline mailing list on the DIR subscription web page.

This data is provided as a service to the workers' compensation community. Please send comments or questions to DWCFeeSchedule@dir.ca.gov.

You may download the Medi-Cal pharmacy fee rates (Zip file, 6.40 MB, updated 03/08/2019 - also available via ftp to www.dir.ca.gov, anonymous login). The file's record layout and instructions are included in the zip file, and may also be viewed here.

You may look up the current price of simple prescriptions by completing the form below and clicking "price." For compound prescription pricing, click here. If you are working from a file with 10 digit NDC numbers, please click here.

NDC number: Please include leading zeros, e.g. 00002026002
Metric decimal number of units: e.g. 100 ea (tablets), 2.5 grams (ointments), 240 ml (or cc's - fluids)
Usual and customary price: (including any dispensing fee) e.g. $12.48
Date of service: e.g. 01/05/2004
Nursing home: Check this box if patient is in a nursing home
No substitutions: Check this box only if the prescription explicitly requires a brand-name drug
Clear form

All fields except "nursing home" and "no substitutions" are required


Pricing is from data as of 2/20/2019.

Workers' compensation pharmaceutical fee schedule — Physician dispensed pharmaceuticals

Legislation that became effective on January 1, 2012 places new caps on fees for pharmaceuticals dispensed by physicians. These new caps are contained in Labor Code section 5307.1.

December 2024