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Changes to the Official Medical Fee Schedule
Take Effect for Dates of Service on or After
March 1, 2015.
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REGISTRATION IS OPEN!
The California Neurology Society (CNS) is pleased to present its NeuroRheumatology Symposium on May 1 and 2, 2015 at the Fess Parker in lovely and scenic Santa Barbara, California.
The NeuroRheumatology Symposium is unique in that it is the first conference dedicated to rheumatic/autoimmune diseases and their neurological presentations.
For additional information, to register or download a brochure, please follow this link.
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DID YOU RENEW YOUR MEMBERSHIP YET?
Hard copy invoices, as well as e-mail reminders have gone out. If you have not received your copy, please contact us at (916) 661-6050 or [email protected] and we'd be glad to take your renewal over the phone or forward an invoice for your convenience.
You can also renew online by following this link.
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February 18, 2015 - Yesterday, the DWC announced implementation of changes to the Official Medical Fee Schedule that will take effect for dates of service on or after March 1, 2015 - less than 10 days from today!
This implementation, delayed by the Division since January 1, 2015 (CSIMS eBlast December, 2014), implements changes to not only the conversion factors used to calculate reimbursement for services, but many of the fundamental ground rules that must be followed to properly bill and reimburse for those services.
By clicking on the "DWC website" link found within the DWCNewsline below, readers will access all the document issued by the Division in support of these most recent changes. Of those documents, the one entitled, "Clean copy of regulation..." represents the clearest indicator of where in the regulation changes have taken place.
The various additional documents found on the DWC's website such as the "Medically Unlikely Edits (MEU)," the "NCCI Policy Manual" and the various documents listed within CCR8, Section 9789.19 (the Update Table) will be the most valuable to look at and understand. Members will notice that report reimbursement has increased very slightly upward - actually only a few cents per page - by virtue of a small rise in the Medical Cost Index (See the Update Table - California Specific Codes).
These increases in report reimbursement are not to be confused with any recommendations issued by the RAND Corporation in conjunction with its current study of report reimbursement. That project remains in process and CNS is very actively involved on your behalf.
Newsline No.: 2015-14 Date: February 18, 2015
DWC Posts Adjustments to Official Medical Fee Schedule (Physician Services/Non-Physician Practitioner Services)
The Division of Workers' Compensation (DWC) has posted an order adjusting the Physician Services/Non-Physician Practitioner Services section of the Official Medical Fee Schedule (OMFS) to conform to relevant 2015 changes in the Medicare payment system as required by Labor Code section 5307.1.
The Physician and Non-Physician Practitioner Fee Schedule based on the federal Resource Based Relative Value Scale (RBRVS) was adopted pursuant to the requirements of Senate Bill 863 (SB 863) and became effective for services rendered on or after January 1, 2014. As mandated by SB 863, the fee schedule starts with separate conversion factors for surgery, radiology, and "all other services" in 2014 and transitions to a single conversion factor (CF) beginning in 2017, for all services except anesthesia. The 2015 transition conversion factors reflect a blend of 50 percent pre-2014 OMFS CF and 50 percent 120% RBRVS Medicare CF.
The Physician and Non-Physician Practitioner Fee Schedule update order adopts revisions to several sections of Title 8 California Code of Regulations, including the following changes:
- Adopts the CMS Medicare National Physician Fee Schedule Relative Value File (RVU file) RVU15A and related files for services rendered on or after March 1, 2015
- Updates the Conversion Factors, applying the Medicare relative value scale adjustments and the Medicare Economic Index (MEI) inflation increase to the transitional conversion factors set forth in the regulation
- Updates the Statewide Geographic Adjustment Factors
- Adopts the 2015 National Correct Coding Initiative Edits/2015 NCCI Policy Manual
Updates the California specific codes with the MEI inflation increase
The administrative director update order adopting the OMFS adjustments effective for services rendered on or after March 1, 2015, can be found on the DWC website. An explanation of changes is attached to the order, identifying the basis for the changes included in the update.
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