Official Medical Fee Schedule (OMFS)
Legal basis: LC §5307.1
Definition
The fee schedule adopted by the DWC Administrative Director that establishes maximum reimbursement rates for medical treatment services in California workers' compensation. The OMFS covers physician services, hospital outpatient and inpatient, pharmacy, pathology, and durable medical equipment based on Medicare RBRVS methodology.
Related Terms
Frequently Asked Questions
What is a Official Medical Fee Schedule (OMFS)?
The fee schedule adopted by the DWC Administrative Director that establishes maximum reimbursement rates for medical treatment services in California workers' compensation. The OMFS covers physician services, hospital outpatient and inpatient, pharmacy, pathology, and durable medical equipment based on Medicare RBRVS methodology.
What is the legal basis for OMFS in California workers' compensation?
Official Medical Fee Schedule is governed by LC §5307.1 under California workers' compensation law. This statute defines the requirements, procedures, and standards for official medical fee schedule in the workers' compensation system as of 2026.
What agency oversees official medical fee schedule in California?
Official Medical Fee Schedule falls under the jurisdiction of California's Division of Workers' Compensation (DWC) per LC §5307.1. The DWC establishes rules, guidelines, and enforcement procedures to ensure compliance across the workers' compensation system.