CHA News Article

DWC Issues Final OMFS Regulations for Hospital Outpatient Departments
Transitions payment for therapy services to new RBRVS payment system

The Division of Workers’ Compensation has adopted and filed an amendment to the hospital outpatient department (HOPD) and ambulatory surgical center fee schedule section of the official medical fee schedule (OMFS). The final regulations, effective Sept. 1, are very similar to the proposed regulations issued April 11. Specifically, the final regulations adopt the 2014 OMFS resource-based relative value system (RBRVS) physician fee schedule for therapy services, diagnostic tests and other non-emergent, non-surgical services. Emergent and surgical procedures performed in the hospital outpatient setting will continue to be paid according to the Medicare outpatient prospective payment system. However, the payment multiplier has been updated to 121.2 percent. In addition, a new “facility only” payment category will be covered under the HOPD OMFS and paid using a 101.01 percent multiplier. The final regulations and RBRVS fact sheet are attached and available on the DWC website, along with FAQs about the RBRVS. Questions about the final regulations can be sent to DWCFeeSchedule@dir.ca.gov.

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