February 3, 2025 – Updates Fee Schedule: Changes Align with Medicare Payment Updates and Take Effect March 1, 2025
Key Updates for Medical Providers
The Division of Workers’ Compensation (DWC) has announced adjustments to the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS). These updates reflect changes in the Medicare payment system as required by Labor Code Section 5307.1 and will take effect March 1, 2025.
What These Changes Mean for Providers
DWC’s fee schedule adjustments directly impact healthcare providers, ambulatory surgical centers, and hospitals that serve injured workers under California’s workers’ compensation system. The changes aim to:
- Ensure reimbursement rates remain consistent with Medicare’s latest payment system.
- Promote transparency and uniformity in payment structures.
- Support medical facilities in delivering high-quality care to injured employees.
These modifications align California’s workers’ compensation medical billing with federal payment structures, ensuring standardized reimbursement rates across different facilities.
How This Impacts Medical Practices
With these adjustments, hospitals and ambulatory surgical centers (ASCs) must review their billing and coding practices to remain compliant. Key considerations include:
- Understanding reimbursement updates: Providers should assess how the changes will impact their financials.
- Updating medical billing systems: Ensuring systems reflect the latest OMFS changes.
- Training administrative staff: Educating billing teams on the new fee schedule requirements.
Where to Find More Information
DWC has published full details on the OMFS updates, including the specific adjustments for hospital outpatient departments and ambulatory surgical centers, on its Official Medical Fee Schedule (OMFS) page.
For ongoing updates on workers’ compensation regulations, medical-legal issues, and policy changes, visit MedLegalNews.com.
Final Thoughts
These fee schedule adjustments are crucial for ensuring fair reimbursement and maintaining alignment with Medicare’s evolving payment model. Medical providers should take proactive steps to review, adapt, and implement necessary changes ahead of the March 1, 2025 deadline.
Source: DWC OMFS Page