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California Department of Industrial Relations

03/08/2018 | Press release | Distributed by Public on 03/08/2018 18:10

DWC Posts Fee Schedule Adjustments for Hospital Outpatient Departments/Ambulatory Surgical Centers

N E W S L I N E

Newsline No.: 2018-17

Date: March 8, 2017

DWC Posts Fee Schedule Adjustments for Hospital Outpatient Departments/Ambulatory Surgical Centers

The Division of Workers' Compensation (DWC) has posted adjustments to 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 changes take effect March 15, 2018.

The public should take note of the following:

  • Recently added 42 C.F.R. section 419.71, Payment reduction for certain X-ray imaging services, became effective January 1, 2018. The OMFS adopts and incorporates by reference section 419.71, and related payment rules, addressing payment reduction for film X-ray imaging services and computed radiography imaging services.

  • Subdivision (a)(1) of section 9789.32 is corrected by deleting status indicator

    "Q4" from the table, for services rendered on or after December 15, 2016. Services assigned status indicator "Q4," clinical laboratory services, are not considered a "supply, drug, device, blood product, or biological." Thus, subdivision (a)(1) is not applicable to codes assigned status indicator "Q4."

  • Composite APCs and comprehensive APCs payment rules are added and incorporated by reference by date of service. The adopted clarifying composite APCs and comprehensive APCs payment rules are declaratory of existing regulations.

More information and the adjustments to the hospital outpatient departments and ambulatory surgical centers section of the OMFS can be found on the DWC OMFSpage.

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The California Department of Industrial Relations,established in 1927, protects and improves the health, safety, and economic well-being of over 18 million wage earners, and helps their employers comply with state labor laws. DIR is

P.O. Box 420603 · San Francisco, CA · 94142-0603 · www.dir.ca.gov

Department of Industrial Relations Newsline No. 2018-17

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housed within the Labor & Workforce Development Agency.For general inquiries, contact DIR's Communications Call Center at 844-LABOR-DIR (844-522-6734) for help in locating the appropriate division or program in our department.