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OMFS Update Alert

September 20, 2017 by Catherine Montgomery

The California Division of Workers’ Compensation (DWC) ordered new adjustments to the Official Medical Fee Schedule (OMFS), effective for services rendered on or after October 1, 2017. The order updates fees for Physician and Non-Physician Practitioner services— including a status code change that, in effect, eliminates reimbursement for CPT 93668.

Pursuant to California Labor Code § 5307.1, DWC Acting Administrative Director George P. Parisotto’s September 12th update order brings the Physician and Non-Physician Practitioner Fee Schedule into conformity with the following changes to Medicare:

Schedule

Changes Made To

October 1, 2017 Medicare Physician Fee Schedule

RVU17D (RVUPUF17, PPRRVU17_OCT, OPPSCAP_OCT, excluding 17LOCCO, ANES_OCT, CY2017_GPCIs)

October 1, 2017 Medicare quarterly update to the Practitioner PTP National Correct Coding Initiative Edits

0001M/36591 – 25931/G0471 

26010/01810 – 36909/J2001

37140/0213T – 60650/G0471

61000/0213T – R0075/R0070

October 1, 2017 quarterly update to the Practitioner Services Medically Unlikely Edits

Access MUE Table Here 

Reimbursement for CPT 93668 for Peripheral Arterial Disease Rehabilitation changed as follows:

CPT 93668

Status Code

Reimbursement

Dates of Service 3/1/2017 to 9/30/2017

N

$27.82

Dates of Service from 10/1/2017

C

$0.00

The order itself is available on the DWC website. The DWC publicized the order in Newsline No.: 2017-83. We’ll keep you updated on any further changes to the OMFS.


DaisyBill’s Work Comp Wizard includes our OMFS calculator, making reimbursement calculations a snap. With 6 official fee schedules, updated with every change to the OMFS, our calculator determines the correct reimbursement for all of your original bills. Try the Work Comp Wizard today.

TRY THE WORK COMP WIZARD

93668: status N -> C. on 9/30, the reimbursement is 27.82, 10/1 it is $0

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