DWC posts additional adjustments to Official Medical Fee Schedule (Hospital Outpatient Departments/Ambulatory Surgical Centers)

NEWSLINE

The Administrative Director of the Division of Workers' Compensation (DWC) issued an Order dated October 3, 2025, adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers section of the Official Medical Fee Schedule (OMFS) to conform to the quarterly changes in the Medicare payment system as required by Labor Code section 5307.1. Subsequently, on November 7, 2025, the Centers for Medicare and Medicaid Services (CMS) issued revised fee schedule documents for the October update.

DWC has posted an order adjusting the Hospital Outpatient Departments and Ambulatory Surgical Centers fee schedule to adopt the following Medicare updates:

Additional October 2025 Quarterly Update

• The CMS Ambulatory Surgical Centers (ASC) Payment Rates - Addenda (updated 11/07/2025)
• As a result of the CMS updates to the ASC Payment Rates - Addenda, updates where made to the OMFS' Surgical Procedure HCPCS.

The updated order dated November 14, 2025 adopting the OMFS adjustments is effective for services rendered on or after October 1, 2025 and is posted on the DWC website's OMFS page.