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California proposes comp fee schedule revamp

Posted On: Feb. 26, 2021 1:05 PM CST


The California Division of Workers Compensation released on Thursday its final proposed medical-legal fee schedule regulations.

The proposed changes to the medical-legal fee schedule, which has not been updated since 2006, largely involves changing the reimbursement structure for comprehensive, follow-up and supplemental workers compensation evaluations. The proposed changes would alter reimbursement from an hourly fee to a flat fee with an additional per-page reimbursement for reviews more than 200 pages in length.

The proposed changes also include clarifying physician obligations when records are received without attestation, deleting several billing codes and adding modifiers to the fee schedule for toxicology and oncology evaluations.

The California DWC held a public hearing on the changes in December and accepted public comments through Dec. 15, 2020, with many physicians publicly disagreeing on the changes.

The final proposed changes will now go to the Office of Administrative Law for approval. If approved, they would take effect April 1.