Earlier this month, we reported on the upcoming changes to the Physician and Non-Physician Services section of the Official Medical Fee Schedule (OMFS). California’s Division of Workers’ Compensation adopted these changes to conform to the Medicare payment system, and the changes roll into effect on March 1, 2017. New conversion factors and an updated RVU file combine to change the reimbursement amounts for all procedure codes – we covered the changes to the twenty most commonly-used Physician and Non-Physician HCPCS in our analysis. Lost in the shuffle of these changes are another critical shift: Changes to the California-specific codes laid out in CCR § 9789.12.14.

Prior to 2014, a suite of California-specific codes were created by the DWC to cover services for which there are no appropriate CPT codes or HCPCS, such as the State of California Primary Physician Progress Report (DWC form PR-2). While the reimbursement rates for these codes are not directly affected by changes to the conversion factor or RVU file, CCR § 9789.12.14 specifies that they must nonetheless be updated annually “in accordance with the Medicare Economic Index.”

The table below lists the new fees for California Specific Codes, effective March 1, 2017, alongside the 2016 rates. All of the reimbursements are due for minor increases in 2017, most by about 1%.

DaisyBill’s OMFS Calculator – one of the six products offered through our Work Comp Wizard – already includes these changes for dates of service on or after March 1. Should you ever need the old figures past that date, you can calculate previous reimbursements through our historical database – simply enter a date of service prior to March 1, 2017.

If you’re curious about our Calculator, sign up below for a three-day trial to the Work Comp Wizard. You’ll be able to start calculating reimbursements instantly, and you’ll gain access to our other workers’ comp tools.

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