CA OMFS 2024: DMEPOS Fee Schedule Update

January 16, 2024 5 min read

By: the daisyNews Team

CA OMFS 2024: DMEPOS Fee Schedule Update

California’s Division of Workers’ Compensation (DWC) updated the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule, effective for services rendered on or after January 1, 2024.

The DWC’s update order alters the DMEPOS fees as follows:

Fee Changes: 3,263 codes (94% of DMEPOS codes)
New DMEPOS: 92 codes
Deleted DMEPOS: 17 codes

This DMEPOS fee schedule update aligns the California Official Medical Fee Schedule (OMFS) with the most recent changes to the Centers for Medicare and Medicaid Services (CMS) fees.

As noted in yesterday’s article on Pathology and Clinical Laboratory changes, the DWC has not updated California's Physician Fee Schedule despite the CMS releasing updated fee files for physician services.

The daisyWizard’s OMFS Calculator and daisyBill RCM software reflect the 2024 DMEPOS reimbursement changes. Details below.

DMEPOS Update Effective For DOS January 1, 2024

The DWC DMEPOS update order, announced in a December 23, 2022 Newsline, updates the DMEPOS fee schedule for all dates of service on or after January 1, 2024 as follows:

2024 DMEPOS Change	HCPCS Code Count	% of HCPCS Code
Fee Increase or Decrease	3,263	94%
No Fee Change	92	3%
New HCPCS Codes	92	3%
Deleted HCPCS Codes	17	0.49%
Total	3464	100.0%

Below is a complete list of the 92 new HCPCS added to the DMEPOS fee schedule per the DWC order along with 2024 reimbursements and modifiers where applicable.

New 2024 DMEPOS HCPCS	Modifier(s)	HCPCS Description	2024 DOS Fee
A4541		Monthly supp use with e0733	$46.42
A4542		Supp ext up limb tremor stim	$605.29
A6520		G com garmnt glove nghttime	$143.45
A6521		G com garmnt glove nght cust	$569.20
A6522		G com garment arm nighttime	$348.56
A6523		G com garment arm nght custm	$827.00
A6524		G com garmnt lwr leg/ft nght	$434.87
A6525		G com garm lwrleg/ft ngt cus	$877.92
A6526		G com garmt full leg/ft nght	$786.22
A6527		G garmt full leg/ft nght cus	$1,445.76
A6528		G com garment bra nighttime	$756.00
A6529		G com garmt bra night custm	$1,194.60
A6530		Compression stocking bk18-30	$44.32
A6533		Gc stocking thighlngth 18-30	$62.23
A6534		Gc stocking thighlngth 30-40	$71.06
A6535		Gc stocking thighlngth 40+	$81.82
A6536		Gc stocking full lngth 18-30	$83.89
A6537		Gc stocking full lngth 30-40	$99.46
A6538		Gc stocking full lngth 40+	$116.45
A6539		Gc stocking waistlngth 18-30	$111.01
A6540		Gc stocking waistlngth 30-40	$132.36
A6541		Gc stocking waistlngth 40+	$156.79
A6552		Grad com stocking bk 30-40	$65.77
A6553		G com stcking bk 30-40 custm	$256.81
A6554		Grad com stocking bk 40+	$90.43
A6555		G com stcking bk 40+ custm	$256.81
A6556		G com stcking thgh18-30 cust	$351.95
A6557		G com stcking thgh30-40 cust	$351.95
A6558		G com stcking thgh 40+ cust	$363.20
A6562		G com stckng waist18-30 cust	$1,151.86
A6563		G com stckng waist30-40 cust	$1,151.86
A6564		G com stckng waist 40+ cust	$1,240.80
A6565		Grad comp gauntlet custom	$199.03
A6566		Grad com garment neck/head	$289.00
A6567		G com garment neck/head cust	$908.02
A6568		G com garment torso/shldr	$188.60
A6569		G com garmnt torso/shdr cust	$1,074.00
A6570		Grad com garment genital	$128.51
A6571		G com garment genital custm	$772.36
A6572		Grad com garment toe caps	$119.24
A6573		Grad com garmnt toe cap cust	$282.96
A6574		Custom gradient sleev/glov	$360.73
A6575		Gradient comp sleev/glov	$116.90
A6576		Custom grad com sleeve med	$221.40
A6577		Custom grad cm sleeve heavy	$183.24
A6578		Gradient comp sleeve	$90.24
A6579		Custom grad com glove med	$355.37
A6580		Custom grad com glove heavy	$352.75
A6581		Gradient comp glove	$82.80
A6582		Gradient comp gauntlet	$55.22
A6583		Grad com wrap w straps bk	$181.66
A6585		Grad com wrap w straps ak	$215.09
A6586		Grad com wrap w straps leg	$633.67
A6587		Grad com wrap w straps foot	$83.00
A6588		Grad com wrap w straps arm	$276.65
A6589		Grad com wrap w straps bra	$109.21
A6594		G comp bandge liner lwr extr	$39.77
A6595		G comp bandge liner upr extr	$39.11
A6596		G comp bandge conform gauze	$0.20
A6597		G comp bandage long stretch	$1.76
A6598		G comp bandage med stretch	$0.85
A6599		G comp bandage short stretch	$1.93
A6600		G com bandge hgh dn foam sht	$3.48
A6601		G com bandge hgh dn foam pad	$3.91
A6602		G com bandge hgh dn foamroll	$5.71
A6603		G com bandge low dn foamchnl	$2.68
A6604		G com bandge low dn foam flt	$1.56
A6605		G com bandage padded foam	$1.79
A6606		G com bandage padded textile	$5.30
A6607		G com bandage tub protct lyr	$1.42
A6608		G com bandage tub protct pad	$5.90
A6610		G com stcking bk 18-30 custm	$256.81
E0530	RR	Electronic posa treatment	$42.65
E0678	RR	Non pneum seq comp full leg	$53.02
E0679	RR	Non pneum seq comp half leg	$30.01
E0680	RR	Non pneum comp control cal	$868.03
E0681	RR	Non pneu comp control w/o ca	$127.82
E0682	RR	Non pneum compress full arm	$72.35
E0732	RR	Ces system	$51.16
E0733	RR	Trans elec nerv for trigemin	$51.16
E0734	RR	Ext up limb tremor stim wris	$515.09
E0735	RR	Non-invasive vagus nerv stim	$51.16
E2001	RR	Suct pum ext urine mgmt sys	$74.96
E2398	NU	Wc dynamic pos back hardware	$187.82
E2398	NU, KU	Wc dynamic pos back hardware	$187.82
E2398	RR	Wc dynamic pos back hardware	$18.78
E2398	RR, KU	Wc dynamic pos back hardware	$18.78
E2398	UE	Wc dynamic pos back hardware	$140.86
E2398	UE, KU	Wc dynamic pos back hardware	$140.86
E3000	RR	Speech volume modulation sys	$281.29
L5615		Ak 4 bar link hydl swg/stanc	$10,076.72
L5926		Endoskel posit rotat unit	$1,068.35

The DWC order also deleted 17 DMEPOS codes as listed below with the (former) 2023 fee.

Deleted DMEPOS HCPCS	Modifier(s)	HCPCS Description	2023 DOS Fee
A6545		Grad comp non-elastic bk	$0.00
K1001	RR	Electronic posa treatment	$41.57
K1002	RR	Ces system	$49.86
K1006	RR	N/A	$73.07
K1009	RR	Speech volume modulation sys	$274.16
K1014		Ak 4 bar link hydl swg/stanc	$9,821.36
K1016	RR	Trans elec nerv for trigemin	$49.86
K1017		Monthly supp use with k1016	$45.24
K1018	RR	Ext up limb tremor stim wris	$502.03
K1019		Supp ext up limb tremor stim	$589.96
K1020	RR	Non-invasive vagus nerv stim	$49.86
K1022		Endoskel posit rotat unit	$1,041.28
K1024	RR	Non pneum comp control cal	$846.04
K1025	RR	Non pneum compress full arm	$70.51
K1031	RR	Non pneu comp control w/o ca	$124.58
K1032	RR	Non pneum seq comp full leg	$51.67
K1033	RR	Non pneum seq comp half leg	$29.26

All daisyBill software, including daisyWizard’s OMFS Calculator, reflect these latest 2024 DMEPOS changes, as well as all the most current reimbursement rates for the entirety of the OMFS, Medical-Legal Fee Schedule (MLFS), and Copy Services fee schedule.

Have questions? For both clients and non-clients, daisyBill experts are available through the chat function (in the bottom right corner of this page) during business hours. Alternatively, drop us a line at info@daisybill.com.

Keep up with the OMFS — or simply stop worrying about it and use our OMFS Calculator, part of daisyWizard’s suite of tools designed to make workers’ comp easy.

TRY FEE SCHEDULE CALCULATOR

0 Reader Comments

There are no comments for this article. Be the first to comment!

How did you like the article ?

DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.