On July 8, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule (OMFS), bringing the OMFS into line with Medicare’s 2019 third quarter changes to reimbursement. This update is retroactive to dates of service rendered on or after July 1, 2019.
This update had no effect on reimbursements.
The DWC order, announced in a recent Newsline, incorporates by reference Medicare’s July 2019 quarterly update to the Medicare Clinical Laboratory Fee Schedule. Specifically, the maximum reasonable fees for pathology and laboratory services shall not exceed 120% of the applicable fees contained in the electronic file “19CLABQ3,” on the Center for Medicare and Medicaid Services (CMS) website.
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