CA Fee Schedule Update: Physician Services (Q4 2025)

September 24, 2025 3 min read

California’s Division of Workers’ Compensation (CA DWC) issued an update to the Physician and Non-Physician Practitioner portion of the state fee schedule for workers’ compensation.

The update adds 61 new Healthcare Common Procedure Coding System (HCPCS) codes, effective for all service dates on or after October 1, 2025.

The update conforms the fee schedule to the relevant 2025 Medicare changes, as California Labor Code Section 5307.1 requires. The CA DWC announced the update in a recent Newsline, and posted the order adopting the update on the CA DWC website.

daisyBIll clients do not need to take any action. Our billing software will automatically apply the changes for all dates of service on or after October 1. We advise non-daisyBill providers to adjust their systems appropriately.

Read on for details!

CA Physician Fee Schedule: 61 New HCPCS Codes

Below are the 61 new HCPCS codes the CA DWC (and Medicare) adopted for Q4 2025.

Note that when Medicare does not assign an HCPCS code a Relative Value Unit (RVU), providers calculate the reimbursement “By Report” (BR). California Code of Regulations Section 9789.12.4 provides specific guidelines for calculating BR code reimbursement rates.

HCPCS	Description	Reimbursement Calculation
A2036	Cohealyx col dml mx pr sq cm	By Report
A2037	G4derm plus, per ml	By Report
A2038	Marigen pacto, per sq cm	By Report
A2039	Innovamatrix fd, per sq cm	By Report
A4288	Replacement breastpump valve	By Report
A9612	Inj, fluorescein, 1 mg	By Report
A9616	Gallium gozellix 1 millicuri	By Report
J0163	Epinephrine in nacl (endo)	By Report
J0164	Epinephrine in nacl (baxter)	By Report
J0458	Aztreonam/avibactam 10 mg	By Report
J0462	Atropine sulf, nte, 0.01 mg	By Report
J0525	Inj cefotetan disodium 10 mg	By Report
J0570	Buprenorphine implant 74.2mg	By Report
J0582	Bivalirudin (endo) 1 mg	By Report
J0614	Inj, treosulfan, 50 mg	By Report
J0668	Instill, bupivac and meloxic	By Report
J0675	Inj, carboprost, 0.1 mg	By Report
J0681	Inj ceftobipole medocarl 3mg	By Report
J0738	Hiv prep, inj, lenacapavir	By Report
J0752	Hiv prep, oral lenacapavir	By Report
J0759	Inj, clevidepine, 1 mg	By Report
J1370	Inj, esomeprazole sod, 1 mg	By Report
J1612	Inj glucagon (gvoke) 0.01 mg	By Report
J1807	Inj, ethacrynate sod, 1 mg	By Report
J1809	Inj, fosdenopterin, 0.1mg	By Report
J1834	Inj, isoniazid, 1 mg	By Report
J2151	Inj, mannitol, 250 mg	By Report
J2291	Inj, nafcillin (baxter) 20mg	By Report
J3290	Inj, tranexamic acid 5 mg	By Report
J3402	Inj. remestemcel-l-rknd/ td	By Report
J3403	Revakinagene, per implant	By Report
J7173	Inj. concizumab-mtci, 0.5 mg	By Report
J7174	Injection fitusiran 0.04 mg	By Report
J9011	Datopotamab deruxtecan, 1 mg	By Report
M0235	Intrav inf, mon anti, fir do	By Report
M0236	Intrav inf, mon anti, sec do	By Report
M0237	Intrav inf, toci, first dose	By Report
M0238	Intrav inf, toci, second dos	By Report
Q0235	Inj, monoclon antibody, 1 mg	By Report
Q0237	Inj, tocilizumab-anoh, hospi	By Report
Q4383	Axolotl graft ult per sq cm	By Report
Q4384	Axolotl dual ult per sq cm	By Report
Q4385	Apollo ft per sq cm	By Report
Q4386	Acesso trifaca per sq cm	By Report
Q4387	Neothelium ft per sq cm	By Report
Q4388	Neothelium 4l per sq cm	By Report
Q4389	Neothelium 4l+ per sq cm	By Report
Q4390	Ascendion per sq cm	By Report
Q4391	Amnioplast double per sq cm	By Report
Q4392	Grafix duo per sq cm	By Report
Q4393	Surgraft ac per sq cm	By Report
Q4394	Surgraft aca per sq cm	By Report
Q4395	Acelagraft per sq cm	By Report
Q4396	Natalin per sq cm	By Report
Q4397	Summit aaa per sq cm	By Report
Q5154	Inj, omlyclo, 5 mg	By Report
Q5155	Inj, aflibercept-jbvf, 1 mg	By Report
Q5156	Inj, tocilizumab-anoh, 1 mg	By Report
Q5157	Inj, denosumab-bmwo, 1 mg	By Report
Q5158	Inj, denosumab-bnht, 1 mg	By Report
Q5159	Inj, denosumab-dssb, 1 mg	By Report

Again, all bills providers submit via daisyBill will automatically reflect the most current, accurate fee schedule rates. If you have any questions regarding this update, use the chat function at the bottom right of this screen or email our experts at info@daisybill.com.

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