The DMEPOS fee schedule is a separate fee schedule from the physician and non-physician fee schedule. For workers' comp, DMEPOS is reimbursed at 120% of the currently adopted Medicare DMEPOS rate for California.
To calculate DMEPOS fee schedule, follow the steps below:
Step 1. Open the DWC's OMFS Page → Click ‘Durable medical equipment, prosthetics, orthotics and supplies’ Link
Step 2. To Download the Latest Fee Schedule Documents → Click Word or PDF Icon
Step 3. From Download → Click the ‘DME16-A’ Link
Step 4. From Medicare Website → Download ‘DME16-A’ ZIP File
Step 5. Open ZIP File → Open ‘DME2016_JAN_V1208’ File in CSV, TXT, or XLSX Format
Make sure you are using the most current fee schedule, as the DWC updates the DMEPOS fee schedule several times a year. Also, the workers' comp DMEPOS fee schedule may not be updated on the same schedule as the Medicare one, so don't rely on only Medicare sources.
IMPORTANT: Don’t make the mistake of thinking the DME amount listed in Medicare’s file is the reimbursement amount. You MUST make the 120% calculation yourself.
California Labor Codes
California Code of Regulations (CCR)
Division of Workers’ Compensation Websites
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