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Q3 2017 DMEPOS Fee Schedule Adopted By DWC

July 7, 2017 by Catherine Montgomery

After keeping us waiting for a few days, the California Division of Workers’ Compensation (DWC) officially posted an order adjusting the Durable Medical Equipment, Prosthetics, and Orthotics (DMEPOS) section of the Official Medical Fee Schedule for the third quarter of 2017. This adjustment by the DWC brings California workers’ comp into alignment with the Medicare payment system.

Intriguingly, the DIR Newsline announcing the change specifies that the updated fee schedule was adopted retroactively. Even though July 1st came and went without an official order, the Newsline states that the Q3 change is “effective for services rendered on or after July 1, 2017.”[1]

Ordinarily, that could cause some confusion. But don’t sweat it – our development team downloaded the new DME-17C file from the Medicare website for analysis and found no existing reimbursement changes for the third quarter of 2017.

Medicare did add a pair of new procedure codes that are now reimbursable under the DMEPOS Fee Schedule:

Procedure Code

Modifier

OMFS Reimbursement

K0553

N/A

$298.05

K0554

NU

$313.54

K0554

RR

$31.35

K0554

UE

$235.16

DaisyBill’s OMFS Calculator, the foundational tool of our Work Comp Wizard, automatically calculates reimbursements using the most recent Medicare files and DWC reimbursement formulas. The Q3 2017 DMEPOS fee schedule is already loaded and active in our software.

Work Comp Wizard subscriptions are just $49 per month, come with a free three-day trial, and are cancellable at any time. You can learn more on our website.

TRY THE WORK COMP WIZARD


[1] See DIR Newsline 2017-58 here.

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