California’s Division of Workers’ Compensation has updated the medical fee schedule for hospital outpatient departments and ambulatory surgical centers, adopting fourth-quarter Medicare changes for services rendered on or after October 1, 2026. The change is one of three related updates covering different categories of workers’ compensation medical services.
DWC announced the outpatient and surgical-center order on October 7. That announcement date is separate from the October 1 service applicability date. The order updates the Official Medical Fee Schedule under Labor Code section 5307.1, which requires the schedule to reflect changes in the Medicare payment system.
Outpatient and surgical-center changes
For hospital outpatient services, the order adopts the October 2026 Medicare Hospital Outpatient Prospective Payment System Addenda A and B. It also adopts specified code entries from Medicare’s October ambulatory surgical-center files and selected portions of the updated Integrated Outpatient Code Editor. These are separate components of the outpatient and surgical-center update.
Practitioner services and medical equipment
An October 2 DWC notice addresses physician and non-physician practitioner services. That order adopts Medicare’s fourth-quarter National Physician Fee Schedule Relative Value File, identified as RVU26D and updated August 26, 2026. It also adopts updated Practitioner Procedure-to-Procedure Edits and Medically Unlikely Edits. Those changes likewise apply to services rendered on or after October 1.
A third notice, published October 5, covers durable medical equipment, prosthetics, orthotics and supplies. That order adopts Medicare’s fourth-quarter 2026 updates for this separate fee-schedule section, with the same October 1 service applicability date.
DWC has posted each order on its corresponding fee-schedule webpage: hospital outpatient departments and ambulatory surgical centers; physician and non-physician practitioner services; and durable medical equipment, prosthetics, orthotics and supplies.
