New Utilization Review for Dialysis Procedures

Effective July 1, 2026, the Office of Workers’ Compensation Programs (OWCP) will implement utilization review for unlisted dialysis procedures billed under procedure code 90999. This utilization review will apply to three OWCP Programs:

  • FECA (DFEC)
  • DCMWC
  • DEEOIC

Dialysis is a medical treatment that removes waste products and excess fluid from the blood in place of kidney function. Dialysis centers are excluded from OPPS pricing. Dialysis facility services must be billed on the OWCP-04 form or institutional bill using the appropriate Revenue Center Codes (RCC) and corresponding service codes. Professional services must be billed separately on the OWCP-1500 form or professional bill.

Please obtain any required prior authorization for DCMWC and DFEC claimants and submit supporting documentation when billing under the claimant’s OWCP program. For DCMWC: To support billing for CPT 90999 documentation must include: thorough description of the dialysis procedure performed, rationale for using an unlisted code instead of a standard dialysis code, time spent and technical details of the dialysis treatment, the date of service, patient's clinical status and treatment response.

Procedure Modifier Maximum Units Utilization Limit
Hemodialysis D8 One unit per day Three units per week
Peritoneal Dialysis (incl. CAPD/CCPD) None One unit per day Seven units per week
Continuous Ambulatory Peritoneal Dialysis (CAPD)  None One unit per day Seven units per week
Continuous Cycling Peritoneal Dialysis (CCPD)  None One unit per day Seven units per week

Bills exceeding these limits may be reduced or denied. The utilization limits will apply to new bills and adjustments of previously paid bills.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist you.

Division of Coal Mine Workers' Compensation (DCMWC):
1-800-638-7072

Division of Energy Employees Occupational Illness Compensation (DEEOIC):
1-866-272-2682

Division of Federal Employees' Compensation (DFEC):
1-844-493-1966

OWCP 1168 Paperless Provider Enrollment

Coming soon: The Office of Workers’ Compensation Programs (OWCP) will transition to a paperless process for all new Provider Enrollment Application (OWCP‑1168) forms, modification requests to existing provider records, and submission of provider enrollment supporting documentation. All provider enrollment applications and updates must be submitted through the Medical Bill Processing Portal | Office of Workers' Compensation Programs portal.

Providers can visit the Provider Enrollment page at Provider Enrollments | OFFICE OF WORKERS' COMPENSATION PROGRAMS to create new applications, recall existing applications, or resubmit rejected applications.

Provider modifications can be submitted through the Provider File Maintenance option after logging into the portal at Provider Login | OFFICE OF WORKERS' COMPENSATION PROGRAMS.

Quick reference guides for registering for portal access and submitting provider record updates are available at Provider Login | OFFICE OF WORKERS' COMPENSATION PROGRAMS.

For questions, contact our Call Center at 1-844-493-1966 where a representative will be happy to assist you.

Authorization Change Emails

Effective April 25, 2026, DFEC and DEEOIC providers will receive an email notification whenever the status of an authorization request changes. Notification will be sent to the contact email address on file for the provider associated with the authorization request. Providers need to verify that their contact email address is current. If an update is needed, refer to the Updating Provider Information in the Provider Portal Quick Reference Guide.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist you.
Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682
Division of Federal Employees' Compensation (DFEC):1-844-493-1966

OWCP Claimant Portal Travel Bill Submission

Effective March 14, 2026, claimants of the Division of Federal Employees’ Compensation (DFEC) and Division of Energy Employees Occupational Illness Compensation (DEEOIC), as well as their authorized representatives (AREPs), will be able to submit Form 957A/957B travel reimbursement requests through the Claimant Portal. Claimants can access the WCMBP Claimant Portal by registering and logging in through Employees' Compensation & Management Portal (ECOMP).

A new feature Submit/View Travel Bill (Form 957A/B) will appear after logging into the claimant portal. This feature allows claimants and AREPs to:

  • Submit new travel reimbursement requests online and upload supporting documentation
  • View previously submitted travel bills entered through the claimant portal.

For DFEC and DEEOIC, paper forms will no longer be necessary for travel bills when submitted through the claimant portal.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist you.

Division of Energy Employees Occupational Illness Compensation (DEEOIC):
1-866-272-2682

Division of Federal Employees' Compensation (DFEC):1-844-493-1966

New DFEC Durable Medical Equipment Utilization Review

Effective February 2, 2026, the Office of Workers' Compensation (OWCP Division of Federal Employees' Compensation (DFEC) Program issued updated guidance concerning utilization limitations and payment exclusions for Durable Medical Equipment (DME) procedure codes.

Please refer to 26-02 DFEC Circular regarding this update.

For additional information, you may contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

Division of Federal Employees' Compensation (DFEC):
1-844-493-1966

OWCP Enrollment Application Enhancement

Effective December 20, 2025, OWCP enhanced the provider enrollment application on the WCMBP Portal. This update pulls data from CMS’s Provider Enrollment, Chain, and Ownership System (PECOS) and the National Plan and Provider Enumeration System (NPPES).

The enhancement simplifies the enrollment process by automatically pre-populating key details—such as name, address, contact information, taxonomy, license, and servicing provider records—from PECOS and NPPES. This reduces manual data entry and streamlines the application, making provider enrollment faster and easier to complete.

Providers must review all pre-populated fields for accuracy prior to submitting the enrollment application.

Providers not enrolled in PECOS or who choose not to use the pre-populated data can still complete the application by manually entering their information.

Please refer to the following tutorials for step-by-step instructions on completing your application:

For more information about PECOS, please refer to the following helpful links:

Here are a few additional helpful tips:

  • Enrollment in CMS PECOS is not required to enroll with OWCP.
  • Servicing providers within a Group Practice do not need to enroll separately. These providers are identified within the Group Practice’s OWCP enrollment application.
  • Facilities, Agencies, Organizations, and Institutions (FAOI or “Facility”) do not need to list servicing providers or have them enroll individually. Facilities should ensure that any associated Group Practices are enrolled so that servicing providers can be properly identified.
  • The selected Enrollment Type determines what information is required when starting an application.
    • Individual providers must begin their application using the provider’s SSN, Type I NPI (for medical providers), and First and Last Name.
    • Group Practices and Facilities must begin their application using the organization’s FEIN, Type II NPI, and Business or Provider Name.
  • Any changes made to PECOS data within the OWCP enrollment application are not sent back to PECOS in a return file.

For questions, contact our Call Center at one of the following applicable phone numbers, where a representative will be happy to assist you.

  • Division of Coal Mine Workers' Compensation (DCMWC):
    1-800-638-7072
  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966

DFEC Special Reports or Forms Utilization Review

Effective November 1, 2025, the Office of Workers’ Compensation Programs (OWCP) Division of Federal Employees’ Compensation (DFEC) Program implemented a new Utilization Review (UR) for special reports or forms billing.

Billing Utilization Review for special reports or forms allows:

  • Up to 12 units per year for services occurring within the first three (3) years from the ill or injured worker’s date of injury.
  • Up to 2 units per year for services occurring more than three (3) years from the ill or injured workers’ date of injury.

For questions, you may contact our Call Center at the phone number listed below, where a representative will be happy to assist you.

  • Division of Federal Employees' Compensation (DFEC) at 1-844-493-1966

Changes to the 2025 OWCP Fee Schedules

Fees for some categories of services will be published separately as standalone fee schedules. Examples include:

  • Home Healthcare Fee Schedule (HHC)
  • Dental Fee Schedule, Durable Medical Equipment, Prosthetics, Orthotic Devices, Orthotics, and Supplies (DMEPOS)
  • Clinical Laboratory Fee Schedule (CLINLAB)
  • Physician-Administered Drugs and Biologicals (PADB)

The Table of Relative Value Units (RVU) and Conversion Factors (CF) will no longer display pay status. The "Pay Status" was removed on the 08/29/2025 file. This change was made to maintain consistency across all OWCP fee schedules, which do not display coverage status within the published schedule. Previously, "Pay Status" served as an indicator of coverage status. To provide more accurate and timely information, coverage status should be determined directly through OWCP's Workers’ Compensation Medical Bill Processing (WCMBP) portal. Providers and claimants should use the "Eligibility Inquiry" function within the portal to confirm whether a specific service code is covered. Accessing this information through the WCMBP portal ensures that providers and claimants are viewing the most current details available.

The Table of RVUs and CFs now includes a new column with the header "Maximum Allowable Amount (MAA)." When the MAA is shown, providers can disregard the RVUs, GPCIs, and CFs to determine MAA payment.

The HHC, dental, and CLINLAB fee schedules now only display the MAA applicable to all service localities. Reimbursements will not be adjusted by geographic practice cost indexes (GPCIs).

Reimbursement for Hearing Aids

Reimbursement for hearing aids is inclusive of all associated costs, including but not limited to dispensing, fitting, programming, and delivery. Separate charges for these services are not authorized as they are considered integral to the provision of the hearing aid device.

DEEOIC Discontinuing Coverage for HCPCS Code A9901

Effective October 1, 2025, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) will discontinue coverage for HCPCS Code A9901. The Office of Workers’ Compensation Programs’ (OWCP) Fee Schedule rates for Durable Medical Equipment (DME) are all inclusive and include the cost of taxes, shipping, delivery, installation, and setup. As such, A9901 will no longer be covered as a separately billable code. Authorization requests received prior to October 1, 2025, will be reviewed and processed as appropriate.

The Department of Labor regularly revises the OWCP Fee Schedule to reflect economic adjustments, including increases and decreases, as deemed necessary for fees associated with certain HCPCS/Current Procedural Terminology (CPT) codes. These adjustments are made in response to shifts in medical inflation rates, industry trends, and other pertinent factors.

For additional questions or concerns related to the OWCP fee schedule, email OWCP-Public@dol.gov.

OWCP Bill Submission Requirement for NPI and Taxonomy

Effective September 20, 2025, the Office of Workers’ Compensation Programs (OWCP) will require all providers to include both the billing National Provider Identifier (NPI) and taxonomy code when submitting bills for services provided to OWCP ill and injured workers. Providers must ensure that the submitted NPI and taxonomy match the information listed in their OWCP provider file.

Additionally, group practices must include servicing or rendering provider NPI and taxonomy when billing a professional claim. The submitted servicing or rendering NPI and taxonomy must be associated with an active servicing provider in the OWCP provider file.

Bills with mismatched or missing data may be delayed or denied.

For billing assistance, use the resources below to ensure NPI and taxonomy details are entered in the correct fields on the billing claim form.

To prevent delays and denials, providers are encouraged to verify their NPI and taxonomy information prior to submitting bills by accessing the Workers’ Compensation Medical Bill Processing (WCMBP) portal at https://owcpmed.dol.gov/. Providers needing assistance with online access may contact our call center at the phone numbers listed below.

Providers needing to update existing information or add new details may do so either electronically or by submitting a paper form by mail or fax.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist.

  • Division of Coal Mine Workers' Compensation (DCMWC):
    1-800-638-7072
  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966

OWCP New Provider Process to Copy Authorization Requests

Beginning September 20, 2025, providers using the OWCP online authorization system will have the option to copy information from a previous authorization request when submitting a new authorization.

Providers can select an existing authorization and select the Copy Authorization button. This will create a new request that mirrors the previous authorization, allowing providers to update service information, save the authorization, upload attachments, and submit the authorization.

When copying a previous authorization request, please note that the following fields cannot be changed: program, authorization type, claimant information, and provider information. Additionally, attachments from the original request will not carry over and must be uploaded again.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966

New OWCP Limitation of Procedure Code by Authorization Type

Effective August 9, 2025, the Office of Workers’ Compensation Programs (OWCP) will limit the procedure codes that can be submitted on an authorization request, based on the authorization type.

This change is applicable to both the Division of Energy Employees Occupational Illness Compensation (DEEOIC) and Division of Federal Employees' Compensation (DFEC).

Providers submitting authorizations requests through the Workers’ Compensation Medical Bill Processing (WCMBP) portal will now receive an error message if the requested procedure code is not applicable for the selected authorization type. The error message will guide the provider by indicating the correct authorization type required for the procedure code.

Providers submitting authorization requests by mail or fax will receive a Returned to Provider (RTP) letter if the requested procedure code is not applicable for the authorization type. The RTP letter will include the reason for return and specify the correct authorization type required for the submitted procedure code.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966

OWCP Servicing NPI Requirement for Group Providers

Effective August 9, 2025, the Office of Workers’ Compensation Programs (OWCP) will require group practices to include the servicing or rendering provider National Provider Identifier (NPI) when billing a professional claim. In addition, group practices must ensure the submitted servicing or rendering NPI is associated with an active servicing provider in the OWCP provider file.

Billing

Please follow the steps below to ensure the servicing NPI is submitted on the bill.

Please note that this requirement is not applicable to providers enrolled as individuals, facilities, or non-medical providers. This requirement is also not applicable to institutional or dental bills.

  • Online (Direct Data Entry DDE): Servicing provider information can be entered on professional bills as the rendering provider in the Provider Information section or at the service line. Refer to the Enter Bills Online Tutorial for instructions and examples.
  • Electronic Data Interchange (EDI): Servicing provider information is submitted in the Professional claim type Appendix A Loop 2310B for Rendering Provider information. Refer to the 837 Companion Guide for more details.
  • Paper: Servicing provider information is entered in Box 24J of the service line on the OWCP 1500 Professional bill form. Refer to the Health Insurance Claim Form (OWCP-1500) instructions for more information.

Provider Enrollment

Professional bills from group practice providers received on or after August 9, 2025, will be denied if submitted without the servicing or rendering NPI, or if the submitted servicing or rendering NPI is not active in the group provider file.

Providers can review and, if needed, update the servicing provider information through the Workers’ Compensation Medical Bill Processing (WCMBP) portal https://owcpmed.dol.gov/, or by paper on the Provider Enrollment Application (OWCP-1168) Form.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist.

  • Division of Coal Mine Workers' Compensation (DCMWC):
    1-800-638-7072
  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966
     

OWCP 90-day Timeframe to Submit Enrollment Applications

Effective July 19, 2025, the Office of Workers’ Compensation (OWCP) will require provider enrollment applications to be submitted within 90 calendar days from the most recent update of the enrollment application. Applications that are started and are not submitted within the 90-day time limit will be deleted, making them unavailable for submission.

Providers will receive courtesy email reminders to complete and submit the enrollment application.

Providers are encouraged to complete all required steps and submit the enrollment application. Select this link to resume or track the in-progress enrollment application. After logging in to the Workers’ Compensation Medical Bill Processing (WCMBP) portal, providers can enter the Application Number and Tax ID (FEIN or SSN) or National Provider Identifier (NPI) and Tax ID to recall the application.

If an application is deleted, providers must start a new enrollment application for submission.

For questions, contact our Call Center at the applicable phone number listed below, where a representative will be happy to assist.

  • Division of Coal Mine Workers' Compensation (DCMWC):
    1-800-638-7072
  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966
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