CHA News Article

Final Regulations for Physician Fee Schedule Published

The Division of Workers’ Compensation (DWC) has published the final regulations pertaining to the revised physician fee schedule (PFS), which became effective Jan. 1. The PFS also covers services of non-physician practitioners, such as physical therapists, occupational therapists, nurse practitioners, physician assistants, clinical social workers, clinical nurse specialists, nurse anesthetists and anesthesiologist assistants. The new PFS is based on the resource-based relative value scale system used by Medicare.

The new system implements the Medicare Multiple Procedure Payment Reduction (MPPR) on physical, occupational and speech therapy services. In addition, it applies various caps on the number of procedures that are reimbursable during a single therapy visit, requiring a written, pre-negotiated fee arrangement if the caps are exceeded. The final regulations are attached, as well as a list of procedures subject to the MPPR. For additional information, visit www.dir.ca.gov/dwc/OMFS9904.htm#6.

 

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