DWC Adopts New Telehealth Code List

DWC Adopts New Telehealth Code List

On June 17, 2022, the Centers for Medicare and Medicaid Services (CMS) released revisions to the list of Medicare Physician Fee Schedule Telehealth Codes, adding six new procedure codes.

In compliance with California Labor Code Section 5307.1,
 the Division of Workers’ Compensation (DWC) updated its recent order adjusting the Official Medical Fee Schedule (OMFS) for Physician and Non-Physician Practitioner Services for 2022, Quarter 3. The update adopts the CMS revised Telehealth List, and applies to all services provided on or after July 1, 2022.

6 Telehealth Services Added Effective 7/1/2022

Procedure Code

Short Descriptor

Status

90901

Biofeedback train any meth

Temporary Addition for the PHE for the COVID-19 Pandemic—Added 6/16/22

97537

Community/work reintegration

Temporary Addition for the PHE for the COVID-19 Pandemic—Added 6/16/22

97763

Orthc/prostc mgmt sbsq enc

Temporary Addition for the PHE for the COVID-19 Pandemic—Added 6/16/22

98960

Self-mgmt educ & train 1 pt

Temporary Addition for the PHE for the COVID-19 Pandemic—Added 6/16/22

98961

Self-mgmt educ/train 2-4 pt

Temporary Addition for the PHE for the COVID-19 Pandemic—Added 6/16/22

98962

Self-mgmt educ/train 5-8 pt

Temporary Addition for the PHE for the COVID-19 Pandemic—Added 6/16/22

The Easiest Way To Ensure Compliant Telehealth Billing

daisyBill makes it easy for physicians to follow best telehealth practices for California workers’ compensation.

The daisyWizard Fee Schedule Calculator renders current reimbursement rates instantly.

All OMFS revisions are reflected in daisyBill, daisyAuth, and daisyWizard.

Adding the required modifier 95 to a procedure code marks the service as performed via telehealth. The ‘Billing Ground Rules’ section under ‘Detailed Explanation’ verifies that the modified procedure code is included in the CMS List of Telehealth Services.

Providers should note that while the ‘Place of Service Type’ is Non-Facility, the ‘Place of Service County’ is the same location that would normally apply if the medical service were provided in-person.


When the OMFS updates, so does daisyBill. We’ll keep track of the nitty-gritty details of workers’ comp so you don’t have to. Try the daisyWizard OMFS Calculator free today.

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