On January 4, 2024, California’s Division of Workers’ Compensation (DWC) updated the Pathology and Clinical Laboratory portion of the Official Medical Fee Schedule (OMFS), effective for services rendered on or after January 1, 2024.

The DWC’s order updated the Pathology Fee Schedule as follows:

• 92 procedure codes (HCPCS) have reimbursement changes
• 33 new pathology codes added
• 1 pathology code deleted

This fee schedule update aligns the OMFS with the most recent changes to Medicare, as required by California Labor Code Section 5307.1.

Of note: While the Centers for Medicare and Medicaid Services (CMS) have released an updated file for physician services, the DWC has not adopted these Medicare changes into the Physician and Non-Physician Practitioner portion of the OMFS.

As always, daisyBill has updated daisyWizard’s OMFS Calculator and daisyBill RCM software with the latest 2024 pathology reimbursements.

Pathology, Clinical Laboratory Changes

A DWC January 4th Newsline announced the adoption of Medicare’s 2024 annual Pathology and Clinical Laboratory update. The table below summarizes the 2024 California Pathology Fee Schedule changes effective for all dates of service on or after January 1st.

The Pathology Fee Schedule update includes the adoption of the CMS’s December 21, 2023 Transmittal 12426, Change Request CR 13467, and maintains 2021 COVID-19-related testing codes and reimbursement rates at 120% of those set by California Medicare Administrative Contractor Noridian.

Below is a comprehensive list of the 33 newly-added pathology procedure codes procedure codes (HCPCS):

A single pathology HCPCS is deleted, as shown below:

Physician Fee Schedule: No News Yet

The DWC has not, as of this writing, adopted 2024 changes to Medicare’s physician fee schedule. However, once issued, we will report any changes to the Physician and Non-Physician Practitioner portion of the OMFS.

daisyBillers may rest assured that all Pathology fee schedule changes are reflected in daisyBill billing software and daisyWizard’s OMFS Calculator.

For any questions regarding fee schedules, please contact us through the chat function in the bottom right corner of this page or email us at info@daisybill.com.

Don’t worry about ever-changing fee schedules — that’s what daisyBill’s for. Get instant, accurate rates with daisyWizard’s OMFS Calculator.

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