In an ongoing effort to better align with industry standards of practice, the Office of Workers’ Compensation Programs (OWCP) is enhancing its medical bill processing system to capture the provider NPI and taxonomy number for billing and servicing providers. Providers are encouraged to include NPI and taxonomy number when billing for services provided to injured or ill workers for the Office of Workers’ Compensation Programs.
Online Bill Entry (web portal direct data entry):
Refer to the Direct Data Entry Billing Tutorial for instructions and examples.
- Web portal fields will be added for providers to include billing and rendering (servicing) NPI and taxonomy.
- Be sure to note that for all claim types, the billing NPI will be added to your bill based on your OWCP provider record. You may update the billing NPI on your bill prior to submitting.
Note: If the wrong billing NPI populates on your bill, please be sure to submit a provider enrollment update with the correct NPI information. For step-by-step instructions, refer to the quick reference guide Updating Provider Information in the Provider Portal - Messaging may appear on the portal to ensure NPI and taxonomy are both entered
Mail (paper form):
Refer to the billing instructions for each claim form by visiting the OWCP Forms and References page and selecting the OWCP Program (DCWMC, DEEOIC, or DFEC).
Health Insurance Claim Form (OWCP-1500):
- Billing provider NPI is to be entered in Box 33a and billing taxonomy is to be entered in Box 33b
Note: If you have been submitting your 9-digit billing OWCP provider ID using Box 33b, please begin entering your OWCP provider ID in Box 33 per the form instructions. - Rendering (servicing) taxonomy and rendering (servicing) NPI are to be entered in Box 24J
For Uniform Health Insurance Claim Form (OWCP-04):
- Billing provider NPI is to be entered in Box 56 and billing taxonomy is to be entered in Box 81CCa
- Attending (servicing) NPI is to be entered in Box 76 and attending taxonomy is to be entered in Box 81CCb
For ADA Dental Claim Forms:
- Billing provider NPI is to be entered in Box 49 and billing taxonomy is to be entered in Box 52a
- Treating (servicing) NPI is to be entered in Box 54 and servicing taxonomy is to be entered in Box 56a
EDI (HIPAA 837s): Refer to the updated 837 Companion Guide.
- 837 file segment details for billing provider NPI and taxonomy
NPI or Taxonomy 837 File Segment NPI Loop – 2010AA
Segment – NM1
NM108: Identification Code Qualifier = XX
NM109: NPITaxonomy Loop – 2000A Segment – PRV
PRV01: BI (Billing)
PRV02: PXC (Qualifier for taxonomy code)
PRV03: Provider taxonomy code
Example: PRV?BI?PXC?207Q00000X~ - 837 file segment details for servicing provider NPI and taxonomy PRV03: Provider taxonomy code
Claim Type Location NPI or Taxonomy 837 File Segment Professional/Dental Header NPI Loop: 2310B — RENDERING PROVIDER NAME
Segment: NM1?82
NM108: Identification Code Qualifier = XX
NM109: NPI
Example : NM1?82?1?DOE?JANE?C???XX?1234567804~Taxonomy Loop: 2310B
Segment: PRV
PRV01: PE (Performing)
PRV02: PXC (Qualifier for taxonomy code)
PRV03: Provider taxonomy code
Example: PRV?PE?PXC?1223G0001X~Line NPI Loop: 2420A — RENDERING PROVIDER NAME
Segment: NM1?82
NM108: Identification Code Qualifier = XX
NM109: NPI
Example: NM1?82?1?DOE?JANE?C????XX?1234567804~Taxonomy Loop: 2420A
Segment: PRV
PRV01: PE (Performing)
PRV02: PXC (Qualifier for taxonomy code)
PRV03: Provider taxonomy code
Example: PRV?PE?PXC?208D00000X~Institutional Header NPI Loop: 2310A - ATTENDING PROVIDER NAME
Segment: NM1?71
NM108: Identification Code Qualifier = XX
NM109: NPI
Example: NM1?71?1?JONES?JOHN????XX?1234567891~Taxonomy Loop: 2310A
Segment: PR
PRV01: AT (Attending)
PRV02: PXC (Qualifier for taxonomy code)
Example: PRVAT?PXC?208D00000X~
New messaging will appear on your remittance voucher to alert you if any of the required NPI or taxonomy information is missing or does not match your provider record. Be sure to view the Explanation of Benefits (EOB) Quick Reference Guide for further details.
For additional information, contact our Call Center at the number listed below, where a Call Center 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
We are excited to announce a “NEW” Provider Manual located on the Workers’ Compensation Medical Bill Processing (WCMBP) portal.
Based on the feedback that we have received from the provider community, we developed a manual that offers important information on billing, authorizations, enrollment, policies, and eLearnings. This new Provider Manual will serve as an all-inclusive resource to ease gaining access to answers about the WCMBP system and services, such as how to maintain provider license, where to submit authorizations, or how to understand bill adjustments and appeals.
Please visit the Featured Content section of the portal website at https://owcpmed.dol.gov/portal/ for more information.
For additional information, please contact our Call Center at the number listed below, where a Call Center 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
Effective October 28, 2023, the Office of Workers’ Compensation Programs (OWCP) will begin a review process to ensure servicing provider license or certification information is active and up to date.
Providers enrolled as a group practice are required to identify servicing (medical) providers during the enrollment process. This new process will send correspondence to the group if any servicing provider license information expires in 60 or 30- days. Groups will be required to update servicing provider license information if the license expiration is forthcoming. If that action is not completed, then the servicing provider record will be terminated from the group. Please note this will not terminate the group’s OWCP provider ID.
Providers can review and update servicing provider information via the Workers’ Compensation Medical Bill Processing (WCMBP) portal at https://owcpmed.dol.gov/ or via paper on the OWCP-1168 located on the Forms and References page.
Online: We encourage providers to use the WCMBP Portal to review and update servicing provider license information, including license expiration date. Please upload a current copy of the professional license or certification for the servicing provider. Servicing provider (medical provider) information, such as SSN, NPI, name, taxonomy and license information are found on "Step 10 – Add Servicing Provider Information." of the online enrollment process.
In addition, providers will be able to review and confirm existing provider record information, such as group NPI, provider contact information, and payment details.
Log in to your account via our website: OWCP Medical Bill Processing Portal (https://owcpmed.dol.gov). We have provided detailed instructions on how to review and verify your OWCP record in the Updating Provider Information Resource Guide. Registration is required for online access. Please refer to the Legacy and New Providers Initial Access and Online Billing (dol.gov) Quick Reference Guide for more information.
Mail: Mail the updated OWCP-1168 Provider Enrollment application along with the Provider Enrollment Cover Sheet and your OWCP Provider ID to the following address:
Provider Enrollment
Department of Labor - OWCP
P. O. Box 8312
London, KY 40742-8312
Fax: Send the updated OWCP-1168 via fax with the Provider Enrollment Cover Sheet and your OWCP Provider ID to 888-444-5335.
The Provider Enrollment Cover Sheet is located on the Forms and References page.
For additional information, please contact our Call Center, 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 will host Virtual Help Session on Friday September 8, 2023, from 3:00 - 4:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
During this open forum, attendees are not obligated to stay for the full hour.
If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.
Tips for the Virtual Help Session call:
- Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
- Participants can participate via voice or chat during the session
- The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
- Providers are not required to attend for the duration of the call
We welcome the opportunity to connect with you!
If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
OWCP will host Virtual Help Session on Friday August 4, 2023, from 11:00 am - 12:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
During this open forum, attendees are not obligated to stay for the full hour.
If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.
Tips for the Virtual Help Session call:
- Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
- Participants can participate via voice or chat during the session
- The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
- Providers are not required to attend for the duration of the call
We welcome the opportunity to connect with you!
If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
The U.S. Department of Labor (DOL) has contracted with myMatrixx®, an Express Scripts Company, to provide Pharmacy Benefit Management (PBM) services to the Office of Workers’ Compensation Programs (OWCP) Division of Energy Employees Occupational Illness Compensation (DEEOIC) and Division of Coal Mine Workers’ Compensation (DCMWC).
All DEEOIC and DCMWC claimants should now have new Medical Benefit Identification Cards (MBIC) and access to myMatrixx®’s nationwide network of participating pharmacies and durable medical equipment. If you are a DEEOIC or DCMWC claimant and still need a new MBIC, please contact the CNSI customer service toll-free number at 1-800-638-7072 for DCMWC or at 1-866-272-2682 for DEEOIC.
Claimants can search for participating pharmacies on the web or by calling myMatrixx®:
- DCMWC - https://blacklung-pharmacy.dol.gov/ or 1-877-880-9215
- DEEOIC - https://energyworkers-pharmacy.dol.gov/ or 1-866-686-9592
As of June 5, 2023, pharmacies have been required to submit their pharmacy transactions to myMatrixx® for payment. Pharmacy providers are encouraged to join the myMatrixx® network and can enroll at www.esiprovider.com.
OWCP will host Virtual Help Session on Friday July 7, 2023, from 5:00 - 6:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
During this open forum, attendees are not obligated to stay for the full hour.
If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.
Tips for the Virtual Help Session call:
- Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
- Participants can participate via voice or chat during the session
- The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
- Providers are not required to attend for the duration of the call
We welcome the opportunity to connect with you!
If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
Effective June 24, 2023, the DFEC and DEEOIC Programs for the Office of Workers’ Compensation Programs (OWCP) will enhance bill processing to prevent denials related to accepted conditions if an approved authorization is on file for the billed service.
No changes are necessary for submitting authorization requests or bills. All approved authorizations will need to match the billing OWCP Provider, OWCP Claimant, date(s) of service, and procedure code. In addition, the DEEOIC program will require the billed diagnosis code to match the authorized diagnosis code.
The following are updates specifically for the DEEOIC program:
- New EOB denial reason 90972 will post if a billed diagnosis code does not match the diagnosis code on the approved authorization.
- The following new EOB denial reason will appear on the Remittance Voucher (RV): “Matching authorization is available, but dx on bill is different from the approved authorization”
- New authorization Edit 61342 will post if an authorization is submitted with a non-payable diagnosis code.
For additional information, please contact our Call Center at the number listed below, where a Call Center 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-CNSI will host Virtual Help Session on Friday June 2nd from 3:00-4:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
During this open forum, attendees are not obligated to stay for the full hour
If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.
Tips for the Virtual Help Session call:
- Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
- Participants can participate via voice or chat during the session
- The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
- Providers are not required to attend for the duration of the call
We welcome the opportunity to connect with you!
If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
Effective May 13, 2023, the OWCP Workers’ Compensation Medical Bill Processing (WCMBP) System will allow authorization match by OWCP ID or Billing NPI for DEEOIC and DFEC bills.
This enhancement will result in decreased denials due to authorization mismatch for providers with multiple locations associated with one billing NPI.
There are no changes to the steps for submitting authorization requests or bills.
Providers should ensure the billing NPI on file is up to date. If the billing NPI associated with your OWCP Provider ID needs to be updated, please use the Maintain Provider Information option on the Medical Bill Processing Portal. Please refer to this link for the Updating Provider Information Resource Guide.
For additional information, please contact our Call Center at the number listed below, where a Call Center 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
Effective May 13, 2023, the Office of Workers’ Compensation Programs (OWCP) Remittance Voucher will be redesigned for providers and claimants to increase understanding of the payments and associated bill statuses.
Enhancements include, but are not limited to:
- Adding new Payment, Recoupment, and Overpayment summary tables to explain payments and overpayments
- Improving the Bill Summary table to explain amount paid in the Bill Payments field, clearly identify overpayments as Amount Due to DOL from this pay period, and show Total Bill Count including total number of Pended Bills (In Process)
- Improving the Bill Detail table to show Billed Units along with a new column of Paid Units, add the Conflict TCN for lines denying for exact duplicate EOB denial reason 80101, and include new columns Deduction Type and Amount and Net Paid Amount to explain how IRS Backup Withholding or Levies are applied to payments
- Creating a new Legend to provide a short description of each table
Remittance Vouchers will continue to be mailed to the mailing address on file and available in PDF format on the Workers’ Compensation Medical Bill Processing (WCMBP) Portal.
An updated Remittance Voucher (RV) user guide will be available after May 13, 2023 on the WCMBP Portal for providers at Provider Payments | OFFICE OF WORKERS' COMPENSATION PROGRAMS (dol.gov) and for claimants at Claimant's Corner | OFFICE OF WORKERS' COMPENSATION PROGRAMS (dol.gov)
For additional information, please contact us at the number listed below, where a Call Center 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-CNSI will host Virtual Help Session on Friday May 5th from 2:30-3:30 pm ET.
Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
During this open forum, attendees are not obligated to stay for the full hour.
If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.
Tips for the Virtual Help Session call:
- Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
- Participants can participate via voice or chat during the session
- The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
- Providers are not required to attend for the duration of the call
We welcome the opportunity to connect with you!
If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
OWCP-CNSI will host Virtual Help Session on Friday April 14th from 11 am to 1 pm ET.
Providers will have an opportunity to join the call to ask general questions regarding the medical bill processing system including enrollment, authorization submission, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.
Tips for the Virtual Help Session call:
- Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
- Participants can participate via voice or chat during the session
- The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
- Providers are not required to attend for the duration of the call
We welcome the opportunity to connect with you!
If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
Ambulatory Surgical Centers should bill for facility charges on the OWCP-1500 using the appropriate AMA CPT® code(s) for the primary, secondary, tertiary, etc. procedures and should use the "SG" modifier with each CPT® code.
Effective October 1, 2022, Outpatient UB-04 billed lines submitted with both the Revenue Center Code (RCC) and a CPT/HCPCS/OWCP procedure code will be priced based on the procedure code fee schedule. This pricing update will apply to bills submitted for DFEC, DEEOIC, and DCMWC.
Please note that there will be no changes for RCC pricing for lines billed without a procedure code.
In addition, this pricing update will not affect the RCC Codes requiring CPT/HCPCS/OWCP Codes for Outpatient Hospital Services, per the OWCP Fee Schedule.
It also will not affect Outpatient Bills (13x or 14x) that are priced via OPPS for DFEC and DEEOIC Programs, or implant lines billed with RCC 0274 – 0279 that require a manufacturer’s invoice for reimbursement (DFEC program only).
Please click this link to visit the OWCP Fee Schedule page for more information.
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 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