California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 4.5 - Division of Workers' Compensation › Subchapter 1 - Administrative Director-Administrative Rules › Article 5.3 - Official Medical Fee Schedule › Section 9789.20 - General Information for Inpatient Hospital Fee Schedule - Discharge on or After July 1, 2004

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) This
					 Inpatient Hospital Fee Schedule section of the Official Medical Fee Schedule
					 covers charges made by a hospital for inpatient services provided by the
					 hospital.
(b) Charges by a hospital
					 for the professional component of medical services for physician services
					 rendered on or after January 1, 2014, shall be paid according to Sections
					 9789.12.1 through
					 9789.19. Services rendered on or
					 after July 1, 2004 but before January 1, 2014 shall be paid according to
					 Sections 9789.10 through
					 9789.11. Services rendered after
					 January 1, 2004 but before July 1, 2004 are governed by the "emergency"
					 regulations that were effective on January 2, 2004. Services rendered on or
					 before January 1, 2004 will be paid according to Section
					 9790, et seq.
(c) Sections
					 9789.20 through
					 9789.25 shall apply to all bills
					 for inpatient services with a date of discharge on or after July 1, 2004.
					 Services for discharges after January 1, 2004, but before July 1, 2004 are
					 governed by the "emergency" regulations that were effective on January 2, 2004.
					 Bills for services with date of admission on or before December 31, 2003 will
					 be reimbursed in accordance with Section
					 9792.1.
(d) The Inpatient Hospital Fee schedule shall
					 be adjusted to conform to any relevant changes in the Medicare payment
					 schedule, including mid-year changes no later than 60 days after the effective
					 date of those changes. Updates shall be posted on the Division of Workers'
					 Compensation webpage at
http://www.dir.ca.gov/DWC/dwc_home_page.htm
.
					 The annual updates to the Inpatient Hospital Fee schedule shall be effective
					 every year on December 1.
(e) Any
					 document incorporated by reference in Sections
					 9789.20 through
					 9789.25 is available from the
					 Division of Workers' Compensation Internet site (
http://www.dir.ca.gov/DWC/dwc_home_page.htm
)
					 or upon request to the Administrative Director at:
DIVISION OF WORKERS' COMPENSATION (ATTENTION:
						OMFS)
P.O. BOX 420603
SAN FRANCISCO, CA 94142
1. New
						section filed 1-2-2004 as an emergency; operative 1-2-2004 (Register 2004, No.
						2). A Certificate of Compliance must be transmitted to OAL by 5-3-2004 or
						emergency language will be repealed by operation of law on the following
						day.
2. Certificate of Compliance as to 1-2-2004 order, including
						amendment of section heading and subsections (c) and (d), transmitted to OAL
						4-30-2004 and filed 6-15-2004 (Register 2004, No. 25).
3. Amendment
						of subsections (c), (d) and (e) filed 12-27-2012; operative 1-1-2013 as a file
						and print only pursuant to Government Code section
						11340.9(g)
						(Register 2012, No. 52).
4. Amendment of subsection (b) filed
						2-4-2015; operative 3-5-2015. Submitted to OAL for printing only pursuant to
						Government Code section
						11340.9
						(Register 2015, No. 6).
Note: Authority cited: Sections
						  133,
						  4603.5,
						  5307.1 and
						  5307.3, Labor
						  Code. Reference: Sections
						  4600,
						  4603.2,
						  5307.1, and
						  5318, Labor
						  Code.