DWC posts adjustments to Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)

NEWSLINE

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

The Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule update order adopts the following Center for Medicare & Medicaid Services (CMS) Medicare changes:

April 2026 Quarterly Update

• The CMS Medicare Hospital Outpatient Prospective Payment System (OPPS) April 2026 Addendum A
• The CMS Medicare OPPS April 2026 Addendum B
• The CMS Ambulatory Surgical Center Payment System, April 2026 ASC Approved HCPCS Code and Payment Rates Column A entitled "HCPCS Code" of "April 2026 ASC AA" and Column A entitled "HCPCS Code" of April 26 ASC EE"
• Certain sections of the CMS Medicare OPPS April 2026 Integrated Outpatient Code Editor (I/OCE), IOCE Quarterly Data Files V271.R0

The order adopting the OMFS adjustments is effective for services rendered on or after April 1, 2026 and is posted on the DWC website's OMFS page.