In the 2016 changes to the Official Medical Fee Schedule (OMFS), the California 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):

1. 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.
2. 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.
3. 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

§ 5307.1

California Code of Regulations (CCR)

§ 9789.60 Durable Medical Equipment, Prosthetics, Orthotics, Supplies

Division of Workers’ Compensation Websites

DWC FAQ

DWC Official Medical Fee Schedule

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