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Still Waiting on Adoption of Q3 DMEPOS Fee Schedule

July 5, 2017 by Catherine Montgomery

The California Division of Workers’ Compensation (DWC) typically posts an order every quarter adjusting the Durable Medical Equipment, Prosthetics, and Orthotics (DMEPOS) section of the Official Medical Fee Schedule. In fact, the DWC is legally required to do so to conform to the Medicare payment system. But even though Medicare released quarter three QME-17C file, the DWC has not yet issued an order to officially adopt it.

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*Update: The DWC announced their adoption of the the third quarter DMEPOS Fee Schedule on the afternoon of July 5, 2017. We'll have more information on the new fee schedule in the coming days.

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Without an order from the DWC, the quarter two DMEPOS fee schedule[a] remains in effect for all 2017 dates of service as of April 1, 2017.

An informal analysis of the DME-17C file shows that there are only two changes in store for quarter three. Specifically, Medicare added a pair of new procedure codes (K0553 and K0554) to its DEMPOS fee schedule. But until the DWC officially adopts the third quarter changes, California providers should not bill these two codes.

As soon as the DWC posts an order adjusting the DMEPOS Fee Schedule to conform to the Medicare payment system, DaisyBill will perform an analysis, integrate the changes into our Work Comp Wizard, and post an update on our blog. Until then, bill as you have been using the quarter two rates – we’ll be back with more information in the days and weeks to come.


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[a]Link to blog

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