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DWC implements update to workers' compensation physician fee schedule

April 15, 2024


The California California Division of Workers’ Compensation (DWC) recently published a notice that updates the Official Medical Fee Schedule for Physician Services/Non-Physician Practitioner Services, effective for dates of service on or after April 1, 2024.

The update adopts the following Medicare April 1, 2024, 2nd quarter changes:

  • CMS’ Medicare National Physician Fee Schedule Relative Value File quarterly update - RVU24B effective April 1, 2024
  • CMS’ Zip Code to Carrier Locality files effective April 1, 2024, quarterly update for locality mapping
  • Updated Practitioner Procedure to Procedure (PTP) Edits
  • Updated Medically Unlikely Edits
  • Adopts increases to the conversion factors for Anesthesia and Services Other Than Anesthesia for relevant Medicare Physician Fee Schedule provisions of the Consolidated Appropriations Act, 2024.

Additionally, DWC has posted a revised Table A which specifies the geographic-adjusted conversion factor for each California locality for anesthesia services.

This update follows the previous DWC adjustment notification that incorporated the following 2024 changes in the Medicare payment system effective February 15, 2024.

  • Updated relative value units
  • Updated Current Procedural Terminology coding
  • Updated conversion factors (including consideration of Medicare relative value scale adjustments; Medicare Economic Index 4.6% inflation factor; relevant provisions of the Consolidated Appropriations Act, 2023)
  • Updated National Correct Coding Initiative Edits
  • Updated Table A – anesthesia conversion factors adjusted for Geographic Practice Cost Index localities
  • Revision of Place of Service codes related to telehealth
  • Updated telehealth list

For more information on the Official Medical Fee Schedule (OMFS), please see the DWC fact sheet and FAQ located on the DWC website or email DWC at DWCFeeSchedule@dir.ca.gov.

 

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