The Centers for Medicare and Medicaid Services (CMS) recently announced their latest update to the Medicare fee schedules, which will impact the reimbursement rules and rates for medical services. Starting January 1, 2024, these updates will have a major impact on the costs of medical expenses related to workers’ compensation (WC). Here’s an in-depth analysis of the significant changes and their potential impacts.

Here are the essential updates in the 2024 CMS Fee Schedules:

The impact of these changes on WC medical costs varies from state to state. Several factors can influence this:

• States that have implemented fee schedules based on CMS rules and rates may see a decrease in the growth of physician costs.
• Variations in the distribution of medical costs across states can be observed in different service categories, including physician services and facility services.

Effective July 1, 2024, California’s DWC has implemented revisions to the Official Medical Fee Schedule (OMFS) for physician and non-physician practitioner services. This update includes the addition of 130 new HCPCS codes and ensures that the OMFS is in line with the changes mandated by California Labor Code Section 5307.1 to the Medicare payment system for 2024. The California OMFS update includes the addition of 130 procedure codes to align with the 2024 Medicare payment scheme and meet state requirements. Some billing systems, such as daisyBill, can automatically update these new codes, while others require manual modification.

The 2024 CMS fee schedules indicate varying reimbursement rate adjustments across states, which have different impacts on workers’ compensation medical expenses. The DWC’s recent upgrade in California aligns with these revisions, ensuring WC medical services comply with Medicare standards. It is important to communicate these changes with stakeholders to handle expenses and ensure compliance effectively.

If you are a medical provider struggling to follow DWC guidelines and keeping up with their constantly changing regulation, stay tuned with MLM. we provide the latest updates and insights that can vastly improve the processes at your practice.