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CA OMFS Inpatient Hospital Fee Schedule Update

November 29, 2018 by Catherine Montgomery

California’s Division of Workers’ Compensation (DWC) posted an adjustment to the Inpatient Hospital section of the Official Medical Fee Schedule (OMFS), effective for discharges occurring on or after December 1, 2018.

This adjustment conforms to changes in the 2019 Medicare payment system as required by Labor Code section 5307.1.

On October 18, a DWC Newsline announced the update order, which adjusts the Inpatient Hospital Fee Schedule to align with changes to Medicare. The order reflects amendments to Title 8 of the California Code of Regulations, sections 9789.20–9789.25.

Amended section 9789.23 reflects the changes to the Composite Rate, Hospital Specific Outlier Factor, and Cost to Charge Ratio for the listed California inpatient hospitals.

Amended section 9789.24 reflects Medicare’s changes to the Relative Weights and Geometric Mean Length of Stay for the listed Medicare Severity diagnosis-related groups.

Changes are explained here, and links to the complete updated regulations can be found on the DWC OMFS website.


Can’t keep up with OMFS changes? Use the OMFS Calculator, included with our Work Comp Wizard. Try it free today.

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