DWC updates hospital outpatient departments and ambulatory surgical centers fee schedule to reflect Medicare changes

NEWSLINE

The Division of Workers' Compensation (DWC) has posted an order updating the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform with the July 2026 Medicare payment system changes, as required by Labor Code section 5307.1.

The order adopts the Medicare 2026 third-quarter update to the Hospital Outpatient Departments and Ambulatory Surgical Centers Fee Schedule and applies to services rendered on or after July 1, 2026, and includes the following updates:

• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) July 2026 Addendum A
• The CMS Medicare OPPS July 2026 Addendum B
• The CMS Ambulatory Surgical Center Payment System, July 2026 ASC Approved HCPCS Code and Payment Rates Column A entitled "HCPCS Code" of "July 2026 ASC AA" and Column A entitled "HCPCS Code" of "July 2026 ASC EE"
• Certain sections of the CMS Medicare OPPS July 2026 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V272.R0

The order is available on DWC's OMFS web page.

The California Department of Industrial Relations' Division of Workers' Compensation monitors the administration of workers' compensation claims and provides administrative and judicial services to help resolve disputes related to claims for workers' compensation benefits.