CHA News Article

Division of Workers’ Compensation Adjusts Fee Schedule
Applies to hospital outpatient departments and ambulatory surgical centers

The Division of Workers’ Compensation has posted adjustments to the hospital outpatient department and ambulatory surgical center section of the Official Medical Fee Schedule to conform to changes in the Medicare payment system, as required by Labor Code section 5307.1. The changes will take effect March 15.

Notable changes include:

  • Recently added Code of Federal Regulations, Title 42, section 419.71, reducing payments for certain imaging services, became effective Jan. 1. The California fee schedule adopts section 419.71, and related payment rules, addressing payment reduction for film X-ray imaging services and computed radiography-imaging services.
  • A correction to subdivision (a)(1) of section 9789.32, deleting status indicator “Q4” from the table for services rendered on or after Dec. 15, 2016. Services assigned status indicator “Q4,” clinical laboratory services, are not considered a “supply, drug, device, blood product, or biological.” Thus, subdivision (a)(1) is not applicable to codes assigned status indicator “Q4.”
  • Payment rules for composite and comprehensive ambulatory payment classifications, which clarify existing regulations, have been added.