California’s Division of Workers’ Compensation (DWC) updated the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) portion of the Official Medical Fee Schedule (OMFS), effective for all dates of services on or after January 1, 2023.

The update aligns the California workers’ comp DMEPOS Fee Schedule with Medicare’s January 2023 DMEPOS Fee Schedule update.

The update adds new DMEPOS procedure codes and procedure code/modifier combinations, while deleting others. Despite cuts in reimbursement rates for Medicare generally, California OMFS reimbursement amounts increased for 2,494 of the 2,579 previously existing DMEPOS procedure codes and code/modifier combinations.

Below we list the added and deleted billing code/modifier combinations. daisyBill software, including our Fee Schedule Calculator, is updated as always with the most current information.

California Labor Code Section 5307.1 requires the OMFS to align with changes to the Medicare system. The DWC announced the changes in a recent Newsline, and posted the update order on its DMEPOS fee schedule web page.

The update adds two new procedure codes, along with combinations of those new codes with previously existing modifiers. The update also deletes 2 procedure codes, along with all code/modifier combinations utilizing the deleted codes.

New DMEPOS Procedure Codes & Combinations

Deleted DMEPOS Procedure Codes & Combinations

daisyBillers may continue billing normally; our system will reflect all applicable changes. As always, we will report any other major fee schedule changes in this space.

Know (and get) exactly what you’re owed for treating injured workers. Get instant, accurate fee schedule calculations with daisyWizard’s OMFS Calculator.

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