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Division of Workers' Compensation - Official Medical Fee Schedule (OMFS)

The Official Medical Fee Schedule (OMFS) is promulgated by the DWC administrative director under Labor Code section 5307.1 and can be found in sections 9789.10 et seq. of Title 8, California Code of Regulations. It is used for payment of medical services required to treat work related injuries and illnesses.

If you have questions regarding the Official Medical Fee Schedule (OMFS) email us at DWCFeeSchedule@dir.ca.gov.

Topics covered in the OMFS include:
Ambulance fees
Durable medical equipment, prosthetics, orthotics and supplies
Inpatient hospital
Medical-legal
Outpatient hospital
Pathology and clinical laboratory
Pharmaceuticals
Physician services


Ambulance fees

In addition to the regulations for services provided on or after Jul. 1, 2008,  for ambulance fees on or after Jan. 1, 2009 use:

  • [SUPERSEDED – DO NOT USE: Order of the administrative director of the Division of Workers' Compensation, Dec.11, 2008 word image version acrobat image version]
  • For reference only, Centers for Medicare and Medicaid Services Sep. 18, 2008, Executive Guidance No. 0531, Change Request 6113 to Pub. 100-04 acrobat image version

In addition to the regulations for services provided on or after Apr. 7, 2008, for ambulance fees on or after Jul. 1, 2008 use:

  • Order of the administrative director of the Division of Workers' Compensation, Dec. 8, 2008 word image version acrobat image version

Centers for Medicare and Medicaid Services 2008 Public Use File, as revised Oct. 1, 2008, which contains the following electronic files:

  • 2008 Ambulance Fee Schedule PUF MIPPA Update. excel image version acrobat image version
  • 10-08_PUF 2008_MIPPA_Update index.acrobat image version
  • CY 2008 fact sheet_update acrobat image version
  • The portion of the regulation of Centers for Medicare and Medicaid Services (CMS) proposed final rule entitled “Subpart H—Fee Schedule For Ambulance Services,” appearing as a part of the proposed final rule of the CMS entitled, “Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2009; E-Prescribing Exemption for Computer-Generated Facsimile Transmissions; and Payment for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies,” filed Nov. 19, 2008, and commencing at Vol. 73 FR 69725. acrobat image version

Centers for Medicare and Medicaid Services Zip Code to Carrier Locality File, as revised Nov. 13, 2008,  which contains the following electronic files:

In addition to the regulations for services provided on or after Jan. 1, 2008, for ambulance fees on or after Apr. 7, 2008 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Centers for Medicare and Medicaid Services 2008 Public Use File, which contains the following electronic files:
  • 2008 Ambulance Fee Schedule PUF Excel image version acrobat image version
  • Index of Ambulance Fee Schedule public use file (Jan - Dec 2008) index acrobat image version
  • CY Ambulance Fee Schedule public use file fact sheet acrobat image version
  • 508 Compliant Version of 2008 Ambulance Fee Schedule PUF Excel image version

In addition to the regulations for services provided on or after Feb. 1, 2007, for ambulance fees on or after Jan. 1, 2008 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Portions of Regulation of Centers for Medicare and Medicaid Services final rule entitled, “C. Ambulance Inflation Factor (AIF) for CY 2008”, appearing as a part of the final rule of The Centers for Medicare and Medicaid Services entitled, “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule, and Other Part B Payment Policies for CY 2008; Revisions to the Payment Policies of Ambulance Services Under the Ambulance Fee Schedule for CY 2008; and the Amendment of the E-Prescribing Exemption for Computer Generated Facsimile Transmissions” (CMS-1385-FC), commencing at Vol. 72 FR 66221 and ending at 66578, filed November 27,2007. acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2007, for ambulance fees on or after Feb. 1, 2007 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Portions of Regulation of Centers for Medicare and Medicaid Services final rule entitled, "Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; and Ambulance Inflation Factor Update for CY 2007" (CMS-1321-FC and CMS-1317-F), commencing at Vol. 71 FR 69623, filed Dec.1, 2006. acrobat image version
  • Centers for Medicare and Medicaid Services electronic files:

    The CY 2007 Public Use File acrobat image version ** PLEASE DESCRIBE THIS IMAGE ** version
    MSAvCBSA acrobat image version ** PLEASE DESCRIBE THIS IMAGE ** version
    ZIPlyout_1 acrobat image version word image version
    ZPLC0107V2 acrobat image version ** PLEASE DESCRIBE THIS IMAGE ** version
    ZPLC0107V2 acrobat image version txt version

In addition to the regulations for services provided on or after Sep. 8, 2005, for ambulance fees on or after Jan. 1, 2007 use:
  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Portion of Regulation of Centers for Medicare and Medicaid Services, "D. Ambulance Inflation Factor (AIF) for 2007", appearing at page 69719 of Vol. 71, Federal Register, as a part of the rule entitled, "Medicare Program; Revisions to Payment Policies, Five-Year Review of Work Relative Value Units, Changes to the Practice Expense Methodology Under the Physician Fee Schedule, and Other Changes to Payment Under Part B; Revisions to the Payment Policies of Ambulance Services Under the Fee Schedule for Ambulance Services; and Ambulance Inflation Factor Update for CY 2007" (CMS-1321-FC and CMS-1317-F), commencing at Vol. 71 FR 69623, filed Dec.1, 2006. acrobat image version

In addition to the regulations for services provided on or after Sep. 8, 2005, for ambulance fees on or after Jan. 1, 2006 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Centers for Medicare and Medicaid Services electronic file electronic file "Jan20052-17-05"
    excel image version acrobat image version
  • Regulation of Centers for Medicare and Medicaid Services entitled "Medicare Program; Coverage and payment of ambulance services; inflation update for CY 2006" (CMS-1294-N) filed Nov.23, 2005. (Federal register Vol. 70 No. 226, Nov. 25, 2005, Vol. 70 FR 71163) acrobat image version

In addition to the regulations for services provided on or after Jan. 2, 2004, for ambulance fees on or after Sep. 8, 2005 through Dec. 31, 2005 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Centers for Medicare and Medicaid Services electronic file electronic file "Jan20052-17-05"
    excel imageversion acrobat image version
  • Centers for Medicare and Medicaid Services document entitled "Medicare Program; Coverage and payment of ambulance service; Recalibration of conversion factor; inflation update for CY 2005" (CMS-1267-N). (Federal register Vol. 69 No. 219, Nov. 15, 2004, Vol. 69 FR 66918) acrobat image version

Durable medical equipment, prosthetics, orthotics and supplies

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after July 1, 2009, use:

  • Order of the administrative director of the Division of Workers' Compensation acrobat image version word image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after January 1, 2009, use:

  • Order of the administrative director of the Division of Workers' Compensation acrobat image version word image version
  • [SUPERSEDED – DO NOT USE: Order of the administrative director of the Division of Workers' Compensation acrobat image version word image version]

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after July 7, 2008, use:

  • Order of the administrative director of the Division of Workers' Compensation acrobat image version word image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Jan. 1, 2008, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • [SUPERSEDED – DO NOT USE: Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version]

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after July 1, 2007, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Apr. 1, 2007, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Jan. 11, 2007, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Jan. 3, 2007, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Nov. 5, 2006, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Jan. 1, 2007, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Dec. 13, 2006, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Nov. 15, 2006, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Oct. 1, 2006, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after July 1, 2006, use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Apr. 15, 2006 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Dec. 15, 2005 please use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for durable medical equipment, prosthetics, orthotics and supplies on or after Sept. 1, 2005 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

Inpatient hospital

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Dec. 1, 2008 use:

  • Order of the acting administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Regulation effective Dec. 1, 2008 (Section 9789.23) Excel image version acrobat image version, is adjusted only as to listed providers, to conform to notice to the final rule published on Dec. 3, 2008 in the Federal Register (Vol. 73 FR 73656) and is entitled “Medicare Program; Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates: Fiscal Year 2009 Wage Index Changes Following Implementation of Section 124 of the Medicare Improvement for Patients and Providers Act of 2008; Notice” (CMS-1390-N2)
  • Order of the acting administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations (sections 9789.22 - 9789.24) word image version acrobat image version
  • Regulation effective Dec. 1, 2008 (section 9789.22) word image version acrobat image version
  • Adjustment to Inpatient Hospital Fee Schedule section 9789.23, hospital cost to charge ratios, hospital specific outliers, and hospital composite factors, to conform to the Medicare FY09 update to the inpatient prospective payment system published on Aug. 19, 2008 in the Federal Register (Vol. 73 FR 48434) and is entitled “Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations; Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Updates to the Long-Term Care Prospective Payment System; Updates to Certain IPPS-Excluded Hospitals; and Collection of Information Regarding Financial Relationships Between Hospitals Final Rules” (CMS-1390-F; CMS-1531-IFC1; CMS-1531-IFC2; CMS-1385-F4), the correction to the final rule published on Oct. 3, 2008, in the Federal Register (Vol. 73 FR 57541), and is entitled “Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations; Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Updates to the Long-Term Care Prospective Payment System; Updates to Certain IPPS-Excluded Hospitals; and Collection of Information Regarding Financial Relationships Between Hospitals; Correction” (CMS-1390-CN; CMS-1531-CN; CMS-1385-CN2), and the notice to the final rule published on Oct. 3, 2008 in the Federal Register (Vol. 73, FR 57888), entitled, “Medicare Program; Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates: Final Fiscal Year 2009 Wage Indices and Payment Rates Including Implementation of Section 124 of the Medicare Improvement for Patients and Providers Act of 2008; Notice” (CMS-1390-N) excel image version acrobat image version
  • Adjustment to Inpatient Hospital Fee Schedule section 9789.24, diagnostic related groups, relative weights, geometric mean length of stay, to conform to the Medicare FY09 update to the inpatient prospective payment system published on Aug.19, 2008 in the Federal Register (Vol. 73 FR 48434) and is entitled “Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations; Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Updates to the Long-Term Care Prospective Payment System; Updates to Certain IPPS-Excluded Hospitals; and Collection of Information Regarding Financial Relationships Between Hospitals Final Rules” (CMS-1390-F; CMS-1531-IFC1; CMS-1531-IFC2; CMS-1385-F4), the correction to the final rule published on Oct. 3, 2008, in the Federal Register (Vol. 73 FR 57541), and is entitled “Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates; Payments for Graduate Medical Education in Certain Emergency Situations; Changes to Disclosure of Physician Ownership in Hospitals and Physician Self-Referral Rules; Updates to the Long-Term Care Prospective Payment System; Updates to Certain IPPS-Excluded Hospitals; and Collection of Information Regarding Financial Relationships Between Hospitals; Correction” (CMS-1390-CN; CMS-1531-CN; CMS-1385-CN2), and the notice to the final rule published on Oct. 3, 2008 in the Federal Register (Vol. 73, FR 57888), entitled, “Medicare Program; Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 Rates: Final Fiscal Year 2009 Wage Indices and Payment Rates Including Implementation of Section 124 of the Medicare Improvement for Patients and Providers Act of 2008; Notice” (CMS-1390-N) excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Jan. 1, 2008 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations (sections 9789.22 - 9789.24) word image version acrobat image version
  • Regulation effective Jan. 1, 2008 (section 9789.22) word imge version ** PLEASE DESCRIBE THIS IMAGE ** version
  • Adjustment to Inpatient Hospital Fee Schedule section 9789.23, hospital cost to charge ratios, hospital specific outliers, and hospital composite factors, to conform to the Medicare FY08 update to the inpatient prospective payment system published on Aug. 22, 2007 in the Federal Register (Vol. 72 FR 47130) entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Final Rule" (CMS-1533-FC), a correction to the final rule published on Oct. 10, 2007, in the Federal Register (Vol. 72 FR 57634) entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction" (CMS-1533-CN2), a second correction to the final rule published on November 6, 2007, in the Federal Register (Vol. 72 FR 62585) entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction" (CMS-1533-CN3), and a notice to the final rule published on Nov. 27, 2007 in the Federal Register (Vol. 72, No. 227, FR 66580) entitled "Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates, the Ambulatory Surgical Center Payment System and CY 2008 Payment Rates, the Hospital Inpatient Prospective Payment System and FY 2008 Payment Rates; and Payments for Graduate Medical Education for Affiliated Teaching Hospitals in Certain Emergency Situations Medicare and Medicaid Programs; Hospital Conditions of Participation; Necessary Provider Designations of Critical Access Hospitals" (CMS-1392-FC, CMS-1533-F2, and CMS-1531-IFC2) excel image version ** PLEASE DESCRIBE THIS IMAGE ** version
  • Adjustment to Inpatient Hospital Fee Schedule section 9789.24, diagnostic related groups, relative weights, geometric mean length of stay, to conform to the Medicare FY08 update to the inpatient prospective payment system published on Aug. 22, 2007 in the Federal Register (Vol. 72 FR 47130) entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Final Rule" (CMS-1533-FC), a correction to the final rule published on Oct. 10, 2007, in the Federal Register (Vol. 72 FR 57634) entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction" (CMS-1533-CN2), a second correction to the final rule published on Nov. 6, 2007, in the Federal Register (Vol. 72 FR 62585) entitled "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Correction" (CMS-1533-CN3), and a notice to the final rule published on November 27, 2007 in the Federal Register (Vol. 72, No. 227, FR 66580) entitled "Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and CY 2008 Payment Rates, the Ambulatory Surgical Center Payment System and CY 2008 Payment Rates, the Hospital Inpatient Prospective Payment System and FY 2008 Payment Rates; and Payments for Graduate Medical Education for Affiliated Teaching Hospitals in Certain Emergency Situations Medicare and Medicaid Programs; Hospital Conditions of Participation; Necessary Provider Designations of Critical Access Hospitals" (CMS-1392-FC, CMS-1533-F2, and CMS-1531-IFC2) excel image version ** PLEASE DESCRIBE THIS IMAGE ** version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Apr. 1, 2007 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Adjustment to Inpatient Hospital Fee Schedule section 9789.23, hospital cost to charge ratios, hospital specific outliers, and hospital composite factors, to conform to CMS' notice of March 23, 2007, published in the Federal Register, Vol. 72, No. 56, FR 13799, entitled, "Medicare Program; Extension of Certain Hospital Wage Index Reclassifications" (CMS-1384-N)  excel imageversion acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Dec. 1, 2006 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Adjustment to Inpatient Hospital Fee Schedule section 9789.24, diagnostic related groups, relative weights, geometric mean length of stay, to conform to CMS' correction of notice of March 23, 2007, published in Federal Register, Vol. 72, No. 56, FR 13798, entitled, "Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates; Final Fiscal Year 2007 Wage Indices and Payment Rates After Application of Revised Occupational Mix Adjustment to the Wage Index; Corrections" (CMS-1488-CN3)
     excel imageversion acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Mar. 1, 2007 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Regulation effective Mar. 1, 2007 (section 9789.22) word image version acrobat image version
  • Regulation effective Mar. 1, 2007 (section 9789.24 - diagnostic related groups, relative weights, geometric mean length of stay) excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Dec. 1, 2006 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations (sections 9789.22 - 9789.24)
    word image version acrobat image version
  • Regulation effective Dec. 1, 2006 (section 9789.22) word image version acrobat image version
  • Revised adjustment to Inpatient Hospital Fee Schedule to conform to Aug. 18, 2006 final rule and additional notice of Oct. 11, 2006 changes in the Medicare payment system - Composite rate, hospital specific outlier threshold and cost to charge ratio - (section 9789.23) excel image version acrobat image version
  • Revised adjustment to Inpatient Hospital Fee Schedule to conform to Aug. 18, 2006 final rule and additional notice of Oct. 11, 2006 changes in the Medicare payment system - diagnostic related groups, relative weights, geometric mean length of stay (section 9789.24) excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Dec. 1, 2005 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations (sections 9789.22 - 9789.24)
    word image version acrobat image version
  • Regulation effective Dec. 1, 2005 (section 9789.22) word image version acrobat image version
  • Revised adjustment to Inpatient Hospital Fee Schedule to conform to Aug. 12, 2005 final rule and correction notice of Sep. 30, 2005 changes in the Medicare payment system - Composite rate, hospital specific outlier threshold and cost to charge ratio - (section 9789.23) excel image version acrobat image version
  • Revised adjustment to Inpatient Hospital Fee Schedule to conform to Aug. 12, 2005 final rule and correction notice of Sep. 30, 2005 changes in the Medicare payment system - diagnostic related groups, relative weights, geometric mean length of stay (section 9789.24) excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Jul. 15, 2005 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version** PLEASE DESCRIBE THIS IMAGE **version
  • Explanation of changes to Title 8, California Code of Regulations (sections 9789.22 - 9789.24)
    word image version** PLEASE DESCRIBE THIS IMAGE **version
  • Regulation effective Jul. 15, 2005 (section 9789.22(i 2 A)) word image version ** PLEASE DESCRIBE THIS IMAGE ** version
  • Revised adjustment to Inpatient Hospital Fee Schedule to conform to Aug. 11, 2004 final rule and correction notices of the Oct. 7, 2004 and Dec. 30, 2004 changes in the Medicare payment system - Composite rate, hospital specific outlier threshold and cost to charge ratio - (section 9789.23) excel imageversion** PLEASE DESCRIBE THIS IMAGE **version
  • Revised adjustment to Inpatient Hospital Fee Schedule to conform to Aug. 11, 2004 final rule and correction notices of the Oct. 7, 2004 and Dec. 30, 2004 changes in the Medicare payment system - diagnostic related groups, relative weights, geometric mean length of stay (section 9789.24) excel image version** PLEASE DESCRIBE THIS IMAGE ** version

In addition to the regulations for services provided on or after Jul. 1, 2004, for inpatient hospital discharges on or after Nov. 29, 2004 use:

  • Order of the administrative director of the Division of Workers' Compensation acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations, section 9789.23 word image version acrobat image version
  • Revised adjustment to Inpatient Hospital Fee Schedule to Conform to the Oct. 1, 2004 changes in the Medicare payment system - Composite Rate,

Medical-legal fee schedule
  • Medical-legal fee schedule training module ** PLEASE DESCRIBE THIS IMAGE ** version

Outpatient hospital

In addition to the regulations for services provided on or after Jul. 1, 2004, for outpatient hospital and ambulatory surgical center services rendered on or after Mar. 1, 2009 use:

  • Order of the acting chief deputy administrative director of the Division of Workers' Compensationword image version acrobat image version
  • Regulation effective Mar. 1, 2009 (Section 9789.31) word image version acrobat image version
  • Order of the acting administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations, sections 9789.31,  9789.32, 9789.33, 9789.34, and 9789.35 word image version acrobat image version
  • [SUPERSEDED - DO NOT USE: Regulation effective Mar. 1, 2009 (Section 9789.31) word image version acrobat image version ]
  • Regulation effective Mar. 1, 2009 (Section 9789.32) word image version acrobat image version
  • Regulation effective Mar. 1, 2009 (Section 9789.33) word image version acrobat image version
  • Regulation effective Mar. 1, 2009 (Section 9789.34 - table A) - County specific wage index and wage adjusted conversion factor excel image version acrobat image version
  • Regulation effective Mar. 1, 2009 (Section 9789.35 - table B) - Hospital specific wage index and wage adjusted conversion factor excel image version acrobat image version

High cost outlier payment methodology under the official medical fee schedule (OMFS)

In addition to the regulations for services provided on or after Jul. 1, 2004, for outpatient hospital and ambulatory surgical center services rendered on or after Mar. 1, 2008 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Regulation effective Mar. 1, 2008 (Section 9789.31) word image version acrobat image version
  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Regulation effective Mar. 1, 2008 (Section 9789.32) word image version acrobat image version
  • Regulation effective Mar. 1, 2008 (Section 9789.33) word image version acrobat image version
  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations, sections 9789.30, 9789.31, 9789.34, and 9789.35 word image version acrobat image version
  • Regulation effective Mar. 1, 2008 (Section 9789.30) word image version acrobat image version
  • [SUPERSEDED – DO NOT USE: Regulation effective Mar. 1, 2008 (Section 9789.31) word image version acrobat image version]
  • Regulation effective Mar. 1, 2008 (Section 9789.34 - table A) - County specific wage index and wage adjusted conversion factor excel image version acrobat image version
  • Regulation effective Mar. 1, 2008 (Section 9789.35 - table B) - Hospital specific wage index and wage adjusted conversion factor excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for outpatient hospital and ambulatory surgical center services rendered on or after Apr. 1, 2007 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Section 9789.35 - table B - Hospital specific wage index and wage adjusted conversion factor is adjusted to conform to CMS' notice of March 23, 2007, published in the Federal Register, Vol. 72, No. 56, FR 13799, entitled, "Medicare Program; Extension of Certain Hospital Wage Index Reclassifications" (CMS-1384-N) excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for outpatient hospital and ambulatory surgical center services rendered on or after Mar. 1, 2007 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations, sections 9789.31, 9789.34, and 9789.35 word image version acrobat image version
  • Regulation effective Mar. 1, 2007 (Section 9789.31) word image version acrobat image version
  • Regulation effective Mar. 1, 2007 (Section 9789.34 - table A) - County specific wage index and wage adjusted conversion factor excel image version acrobat image version
  • Regulation effective Mar. 1, 2007 (Section 9789.35 - table B) - Hospital specific wage index and wage adjusted conversion factor excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for outpatient hospital and ambulatory surgical center services rendered on or after Feb. 15, 2006 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations, sections 9789.30, 9789.31 and 9789.33 - 9789.35 word image version acrobat image version
  • Regulation effective Feb. 15, 2006 (Section 9789.30) word image version acrobat image version
  • Regulation effective Feb. 15, 2006 (Section 9789.31) word image version acrobat image version
  • Regulation effective Feb. 15, 2006 (Section 9789.33) word image version acrobat image version
  • Regulation effective Feb. 15, 2006 (Section 9789.34 - table A) - County specific wage index and wage adjusted conversion factor excel image version acrobat image version
  • Regulation effective Feb. 15, 2006 (Section 9789.35 - table B) - Hospital specific wage index and wage adjusted conversion factor excel image version acrobat image version

In addition to the regulations for services provided on or after Jul. 1, 2004, for outpatient hospital and ambulatory surgical center services rendered on or after Jul. 15, 2005 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version
  • Explanation of changes to Title 8, California Code of Regulations, sections 9789.31 and 9789.33 - 9789.35
    word image version acrobat image version
  • Regulation effective Jul. 15, 2005 (Section 9789.31) word image version acrobat image version
  • Regulation effective Jul. 15, 2005 (Section 9789.33) word image version acrobat image version
  • Revised adjustment to Outpatient Hospital and Ambulatory Surgical Center Fee Schedule to conform to the Nov. 15, 2004 final rule and correction notice of the Dec. 30, 2004 changes in the Medicare payment system - County specific wage index and wage adjusted conversion factor (section 9789.34 - table A)
    ** PLEASE DESCRIBE THIS IMAGE ** version acrobat image version
  • Revised adjustment to Outpatient Hospital and Ambulatory Surgical Center Fee Schedule to conform to the Nov. 15, 2004 final rule and correction notice of the Dec. 30, 2004 changes in the Medicare payment system - Hospital specific wage index and wage adjusted conversion factor (section 9789.35 - table B)
    ** PLEASE DESCRIBE THIS IMAGE ** version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2009, for pathology and clinical laboratory fees on or after Jan. 1, 2009 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2008, for pathology and clinical laboratory fees on or after Jan. 1, 2008 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for pathology and clinical laboratory fees on or after Jan. 1, 2007 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for pathology and clinical laboratory fees on or after Apr. 15, 2006 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jan. 1, 2004, for pathology and clinical laboratory fees on or after Sept. 1, 2005 use:

  • Order of the administrative director of the Division of Workers' Compensation word image version acrobat image version

In addition to the regulations for services provided on or after Jul. 15, 2004, for physician services on or after Feb. 15, 2007 use:

In addition to the regulations for services provided on or after Jul. 15, 2004, for physician services on or after May 14, 2005 use:

In addition to the regulations for services provided on or after Jul. 15, 2004, for physician services on or after Jan. 14, 2005 use:


Order of the administrative director of the Division of Workers' Compensation rescinding two previous administrative director orders word image version acrobat image version

For services provided on or after Jul. 1, 2004 use:

  • The 1999 edition of OMFS
  • Regulations effective Jul. 1, 2004 (Sections 9789.10 through 9789.111) word image version acrobat image version
  • Insert Pages for the OMFS effective Jul. 12, 2002 word image version acrobat image version)
  • General Instructions (Physician Services) effective Jul. 1, 2004 word image version acrobat image version
  • Table A 9789.11  excel image version acrobat image version
The links referenced in the fee schedule regulations effective Jul. 1, 2004 are:
For services provided between Jan. 1, 2004 and Jun. 30, 2004 use:
For services provided between Jul. 12, 2002 and Dec. 31, 2003 use:
  • The 1999 edition of the OMFS
  • Regulations effective Jul. 12, 2002 word image version acrobat image version
  • Insert pages for the OMFS effective Jul. 12, 2002 word image version acrobat image version
  • OMFS Prosthetics Fee Schedule effective Jul. 12, 2002 acrobat image version

For services provided between Apr. 1, 1999 and Jul. 11, 2002 the 1999 edition of the OMFS should be used. Click here for the order form fillable image

January 2009

 
 
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