Workers’ Comp Fee Schedule Changes: Hospital Outpatient Departments/Ambulatory Surgical Centers

The Division of Workers’ Compensation (DWC) has adjusted the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS). This is required by Labor Code section 5307.1 – and is designed to adjust to changes in the Medicare payment field. These changes will go live as of March 15th.

The changes (copied and pasted below) are as follows:

  • “Recently added Code of Federal Regulations, Title 42, 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.”

For more information, click here.

*The materials provided on this website are for informational purposes only. The materials are not for the purpose of providing legal advice. Please contact your legal counsel to obtain official advice regarding legal matters.

About Desiree Mohazab

Desiree Mohazab, founder of Doc411 (formerly known as California MPN Providers, Inc.) has been in the industry for 22 years. Desiree has a diverse background of experience and has worked with hundreds of doctors and lawyers throughout her career. In 1996, Desiree founded Doc411 from her home - during this time she spent many years going to court hearings and negotiating with attorneys to settle cases, all while managing billing collections. As an entrepreneur with the passion to transform the workers’ compensation and personal injury processes for everyone, she built a network of medical providers for attorneys and their clients. Over its 22 years in business, Doc411 has continued to grow, expanding its services to marketing for all medical providers, pharmacy, and laboratory services. Inspired by her father, a general surgeon and founder of Soraya Hospital in Shiraz, Iran who exhibited great compassion and dedication towards patients, Desiree continues to develop services that provide a better patient and professional experience.