Fee Schedule

CA OMFS: DMEPOS Fee Schedule Update Effective 10/1/2019

In Newsline No.: 2019-75, the California Division of Workers’ Compensation (DWC) announced updates to the Official Medical Fee Schedule for Durable Medical Equipment, Prosthe...

CA OMFS: Pathology/Clinical Lab Fee Schedule Update Effective 10/1/2019

On October 4, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedu...

CA OMFS: DMEPOS Fee Schedule Update Effective 7/1/2019

In Newsline No.: 2019-53, the California Division of Workers’ Compensation (DWC) announced updates to the Official Medical Fee Schedule for Durable Medical Equipment, Prosthe...

CA OMFS Update: Pathology/Clinical Lab Fee Schedule for 7/1/2019

On July 8, 2019, California’s Division of Workers’ Compensation (DWC) ordered an update to the Pathology and Clinical Laboratory section of the Official Medical Fee Schedule ...

CA Physician MUE Reimbursement Change as of 7/1/2019

In Newsline No.: 2019-46, the California Division of Workers’ Comp (DWC) announced changes to the Official Medical Fee Schedule for Physician Services / Non-Physician Practit...

Let's Make This Clear: Workers' Comp Is Not Medicare

A recent post by Joe Paduda perpetuates the common but incorrect practice of analogizing workers’ comp to Medicare. In his discussion, Paduda notes that Medicare pays much le...

Alert: More Unreasonable Physician Reporting Demands

When it comes to billing complications, some California payers are demanding documentation for time-based procedure codes; a demand that is unsubstantiated by California work...

8 Minute How-To: Multiple Procedure Payment Reduction (MPPR)

This short, free, and super-useful video demystifies Multiple Procedure Payment Reductions (MPPRs) for Physician and Non-Physician Practitioner Services in California.

9 Minute How-To: Geographic Practice Cost Indices (GPCIs)

Confused by the 2019 introduction of Geographic Practice Cost Indices (GPCIs) to Physician Services reimbursements?In just nine minutes you will know the reason Fresno...

Assistant at Surgery: All You Need to Know

Last week, we opened Pandora’s box on co-surgeons and team surgery. Notably left in the box was a discussion on assistant(s) at surgery. Typically this arises when physicians...

📬 Payer Responses: Guile, Waiting, and Crickets 🏏

Today we report on the responses from Sedgwick, Liberty Mutual, York, and State Compensation Insurance Fund (SCIF), following our posts detailing their systematic underpaymen...

Co-Surgery vs. Team Surgery: All You Need to Know

Surgery in workers’ compensation cases opens a Pandora’s box: reserves go up, nurse case managers get involved, and surgeons need to justify every detail of their billing to ...