DWC updates hospital outpatient department and ambulatory surgical center fee schedule for October 2026 Medicare changes

NEWSLINE

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

The order adopts the following fourth-quarter 2026 Medicare updates for services rendered on or after October 1, 2026:

• Centers for Medicare & Medicaid Services' (CMS) Medicare Hospital Outpatient Prospective Payment System (OPPS) October 2026 Addendum A
• CMS Medicare OPPS October 2026 Addendum B
• CMS Ambulatory Surgical Center (ASC) Payment System October 2026 files for approved Healthcare Common Procedure Coding System (HCPCS) codes and payment rates, specifically Column A, entitled "HCPCS Code," in the "Oct 2026 ASC AA" and "Oct 2026 ASC EE" files
• Certain sections of the CMS Medicare OPPS October 2026 Integrated Outpatient Code Editor (IOCE), IOCE Quarterly Data Files V273.R0

The order is available on DWC's Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule webpage.

The California Department of Industrial Relations' Division of Workers' Compensation monitors the administration of workers' compensation claims and provides administrative and judicial services to help resolve disputes related to claims for workers' compensation benefits.