In the 2016 changes to the physician fee schedule, the DWC introduces two new columns to the DME file: CA (NR) and CA (R).
- CA(NR) stands for California Non-Rural
- CA(R) stands for California Rural.
These three DWC rules apply to CA (NR) and CA (R):
- For the services on or after January 1, 2016, payment shall not exceed 120% of the fee set forth for the HCPCS code in the CA (NR) column.
- But if the injured worker’s residence zip code appears on the DMERuralZIP file, the fee shall not exceed 120% of the fee set forth in the CA (R) column.
- When the CA (R) for the code is listed as “0.00” the fee shall not exceed 120% of the CA (NR) fee, regardless of whether the injured worker’s address zip code is rural or non-rural.
California Labor Codes
California Code of Regulations (CCR)
Division of Workers’ Compensation Websites
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