California Workers’ Comp Division Files Medical Fee Schedule Amendment

California’s Division of Workers’ Compensation has adopted and filed an amendment to the official medical fee schedule hospital outpatient departments and ambulatory surgical centers section with the Secretary of State.

The amended regulation institutes a payment model in which the maximum allowances for all hospital outpatient department services that are payable under the Medicare hospital outpatient departments prospective payment system be determined based on:

• The Medicare hospital outpatient departments prospective payment system;
• Expands the definition of surgical procedure HCPCS codes to align with Medicare’s hospital outpatient departments prospective payment system surgical procedures;
• Adjusts the fee schedule to conform to relevant changes in the Medicare hospital outpatient departments prospective payment system for calendar years 2015 and 2016.

The regulation amends title 8 of the California Code of Regulations sections, and is effective Dec. 15. The regulation can be found on the DWC website.

Related:

• California’s Workers’ Comp Division Posts Adjustments to Medical Fee Schedule