February 4, 2025 | Sacramento, CA — MedLegalNews.com — DWC ambulance fee schedule revisions take effect for 2025, aligning with recent Medicare payment adjustments and extending temporary add-on payments for ambulance services statewide.
The Division of Workers’ Compensation (DWC) has released a revised adjustment to the ambulance fee schedule within the Ambulance Services section of the Official Medical Fee Schedule (OMFS). This update, effective January 1, 2025, ensures compliance with Labor Code section 5307.1 and aligns reimbursement rates with Medicare’s 2025 payment updates. By adopting these revisions, DWC aims to maintain consistency across federal and state compensation systems, reducing administrative discrepancies for ambulance service providers.
The DWC ambulance fee schedule revisions also reflect ongoing efforts to support equitable reimbursement for emergency medical transport providers serving injured workers. These updates recognize the rising operational costs associated with fuel, staffing, and medical equipment while ensuring that providers continue to receive fair and predictable payments.
Additionally, this alignment with Medicare’s framework strengthens billing transparency and enhances payment accuracy within California’s workers’ compensation system. Providers are encouraged to review the updated schedule closely to confirm compliance and prevent potential claim denials or reimbursement delays once the changes take effect.
Key Updates to the DWC Ambulance Fee Schedule
- On December 3, 2024, DWC issued an initial adjustment to align the OMFS Ambulance Services with Medicare’s 2025 payment system.
- Later, on December 23, 2024, the Centers for Medicare and Medicaid Services (CMS) revised the Ambulance Fee Schedule after the American Relief Act 2025 extended temporary add-on payments for ambulance services.
- In response, DWC issued a new order, replacing the earlier December 3, 2024, order and adopting Medicare’s latest fee schedule.
Impact on Providers and Workers’ Compensation Claims
Ambulance service providers must follow the updated ambulance fee schedule for services on or after January 1, 2025. These adjustments ensure fair reimbursement and consistency in workers’ compensation claims, aligning with Medicare’s 2025 payment updates to support transparency and compliance.
These updates also emphasize the importance of accurate billing and documentation for ambulance providers participating in California’s workers’ compensation system. By aligning with Medicare’s latest payment structure, the revised ambulance fee schedule helps prevent underpayment disputes, promotes administrative consistency, and ensures injured workers continue receiving timely and reliable emergency transport services across the state.
“DWC revises ambulance fee schedule for 2025, updating reimbursement rates to align with industry standards and ensure fair compensation for services.”
For full details, visit the DWC OMFS Ambulance Fee Schedule webpage.
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FAQS: Ambulance Fee Schedule Updates and Provider Guidance
What changes were made in the DWC ambulance fee schedule for 2025?
The 2025 DWC ambulance fee schedule reflects Medicare payment adjustments and includes extended temporary add-on payments for ambulance services.
How does the revised DWC ambulance fee schedule affect providers?
Providers must apply the updated reimbursement rates for services on or after January 1, 2025, ensuring fair payment and compliance with DWC regulations.
Why did DWC revise the ambulance fee schedule twice in December 2024?
DWC updated the schedule after CMS released a revision extending temporary add-on payments under the American Relief Act 2025.
Where can providers access the official DWC ambulance fee schedule?
The full details and current reimbursement rates are available on the DWC OMFS Ambulance Fee Schedule webpage
.