Frequently Asked Questions
Accessing the DWC Pharmaceutical Fee Schedule
To find the Pharmaceuticals Fee Schedule, navigate to the Department of Industrial Relations Official Medical Fee Schedule (OMFS) website which hosts the pharmaceutical fee schedule calculator.
Step 1. From OMFS Page → Click ‘Pharmaceuticals’
Step 2. Click ‘Fees for pharmaceuticals’
Use the Workers’ compensation pharmacy fee schedule - Simple prescription page to:
- Download the current Medi-Cal pharmacy fee rates, and
- Calculate the current price of simple prescriptions.
Every Wednesday the DWC updates the reimbursement amounts listed in the DWC Pharmacy Fee Schedule. Each Wednesday the changes to the Pharmacy Fee Schedule include the following:
- New NDC numbers with reimbursements
- Existing NDC numbers with new reimbursement amounts
- Deletion of existing NDC numbers and reimbursements
For NDC numbers deleted by a weekly update, the Pharmacy Fee Schedule incorrectly states “No record matches the NDC number with a price date on or before xx/xx/xxxx.” However, those deleted NDC numbers remain valid and reimbursable for their prior effective dates of service. For more information, please see this FAQ: Does the DWC Pharmacy Fee Schedule work for past dates of service?
Technology is your friend when it comes to calculating correct fee schedule reimbursements. DaisyBill’s Work Comp Wizard makes determining accurate reimbursements quick and hassle-free for current AND past dates of service.
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