DWC increases reimbursement for telephone visit E/M codes

May 13, 2020

The California Division of Workers’ Compensation (DWC) on Tuesday announced that it will increase the reimbursement for telephone evaluation and management (E/M) codes (CPT codes 99441, 99442, 99443). According to the order, DWC will increase reimbursement of these telephone services retroactive to March 1, 2020, providing parity with office visit E/M codes for services rendered in person or by audio/video telehealth.

This increase mirrors the Medicare changes announced on April 30, 2020, to increase reimbursement rates for telephone visit codes.

DWC has advised that workers’ compensation claims administrators should adjust their payment systems to reflect the changes and reconsider claims for services rendered on or after March 1, 2020, that may have additional payment due to providers. If providers believe that the revised fee schedule would result in an increased payment for services rendered, they may submit corrected bills or requests for second bill review as appropriate.

For more information about providing telehealth services during the COVID-19 public health emergency, see the CMA COVID-19 Telehealth Toolkit for Medical Practices.


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