Pursuant to Labor Code section 5307.1(g)(2), the Division of Workers’ Compensation (DWC) has issued an Administrative Director Order posting adjustments to the Resource Based Relative Value Scale (RBRVS)-based physician services and non-physician practitioner services section of the official medical fee schedule (OMFS) to conform to changes in the 2014 Medicare payment system as required by Labor Code section 5307.1. The update order includes adoption of the 2014 relative value units, the 2014 CPT codes, and updated conversion factors (including the Medicare Economic Index and relative value scale adjustments). The changes take effect January 1, 2014.

In accordance with SB 863, the Acting Administrative Director conducted a rulemaking action and adopted the new physician fee schedule based upon the RBRVS. The regulations were filed with the Secretary of State for publication in the California Code of Regulations on September 24, 2013. Thereafter, amendments to the regulations were adopted to amend the RBRVS-based fee schedule to eliminate use of the federal Office of Workers’ Compensation Program (OWCP) relative value units because the structure of the OWCP data file would result in erroneous fee calculations for 21 procedures. (A total of 81 procedures that would have been priced using OWCP values will instead be paid By Report.) The amended regulations were adopted on December 13, 2013 and submitted to the Office of Administrative Law to be effective January 1, 2014.

The RBRVS-based fee schedule for physician and non-physician practitioner services (based on the regulations and the update order) is posted on the DWC official medical fee schedule webpage. The regulations and update order are effective for services rendered on or after January 1, 2014.

More information and the adjustments to the physician services and non-physician practitioner services section of the OMFS can be found on the DWC OMFS page.