Effective October 26, 2024, the Office of Workers’ Compensation Programs (OWCP) will implement new utilization review to assign limits for specific services.

This utilization review will apply to three OWCP Programs: FECA (DFEC), DCMWC, DEEOIC.

New limits have been defined for the following services:

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

Effective August 24, 2024, providers will be required to submit billing NPI when billing for services provided to injured or ill workers for the Office of Workers’ Compensation Programs (OWCP). Professional and institutional bills submitted without the billing NPI after August 24,2024 will be denied.

Note: Providers are strongly encouraged to submit the billing taxonomy.

Billing NPI is not required for OWCP bills submitted from providers such as non-medical vendors, fiscal intermediaries, and non-emergency transportation.

• 33 Contract Medical Consultant
• 41 Contract Nurse
• 43 Taxi
• 44 Public Transportation & Private Transportation
• 53 Non-Medical Vendor
• 55 Vocational Rehabilitation (Training, Tuition and Schools)
• 56 Vocational Rehabilitation Counselor
• 57 Rehabilitation Maintenance
• 58 Assisted Re-employment
• 59 Relocation Expenses
• 61 Second Opinion Contractor
• 80 Pay-to-Intermediary
• 89 Federal Facility (VA Hospital)
• 94 Boarding House
• 95 Insurance Company (Third Party Carriers)
• 97 Billing Agent
• 98 Lien holder

Online Bill Entry (web portal direct data entry): Refer to the Direct Data Entry Billing Tutorial for instructions and examples.

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 (DCMWC, DEEOIC, or DFEC).

Additional Reminders:

For the Health Insurance Claim Form (OWCP-1500):

• Enter billing information in Box 33. Billing provider NPI must be entered in Box 33a. Enter billing taxonomy in Box 33b.
• Be sure to enter your OWCP Provider ID in Box 33 per the form instructions. Do not enter your 9-digit billing OWCP provider ID using Box 33b.
• Enter servicing facility information in Box 32. Enter servicing facility NPI in Box 32a and servicing facility taxonomy in Box 32b.
• Enter servicing (rendering) provider information in Box 24J. Enter servicing (rendering) NPI in the unshaded area of Box 24J and servicing (rendering) taxonomy in the shaded area of Box 24J.

For Uniform Health Insurance Claim Form (OWCP-04):

• Billing provider NPI must be entered in Box 56. Enter billing taxonomy in Box 81CCa.
• Enter attending (servicing) provider NPI in Box 76 and attending (servicing) taxonomy in Box 81CCb.

For ADA Dental Claim Forms:

• Billing provider NPI should be entered in Box 49. Enter billing taxonomy in Box 52a.
• Enter treating (servicing) NPI in Box 54 and treating (servicing) taxonomy 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 (REQUIRED) NM109: Identification Code Qualifier = NPI (REQUIRED)
  Taxonomy	Loop – 2000A Segment – PRV PRV01: BI (Billing) PRV 01 is required if PRV loop is present PRV02: PXC (Qualifier for taxonomy code) PRV02 is required if PRV01 is present PRV03: Provider taxonomy code PRV03 is required if PRV02 is present Example: PRV✽BI✽PXC✽207Q00000X~

• 837 file segment details for servicing provider NPI and taxonomy

  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 NM109 is required when NM108 is available Example : NM1✽82✽1✽DOE✽JANE✽C✽✽✽XX✽1234567804~
  		Taxonomy	Loop: 2310B - RENDERING PROVIDER SPECIALTY INFORMATION Segment: PRV PRV01: PE (Performing) PRV01 is required if PRV loop is present PRV02: PXC (Qualifier for taxonomy code) PRV02 is required if PRV01 is present PRV03: Provider taxonomy code PRV03 is required if PRV02 is present Example: PRV✽PE✽PXC✽1223G0001X~
  	Line	NPI	Loop: 2420A — RENDERING PROVIDER NAME Segment: NM1✽82 NM108: Identification Code Qualifier = XX NM109: Identification Code Qualifier = NPI NM109 is required when NM108 is available Example: NM1✽82✽1✽DOE✽JANE✽C✽✽✽✽XX✽1234567804~
  		Taxonomy	Loop: 2420A — RENDERING PROVIDER SPECIALTY INFORMATION Segment: PRV PRV01: PE (Performing) PRV01 is required if PRV loop is present PRV02: PXC (Qualifier for taxonomy code) PRV02 is required if PRV01 is present PRV03: Provider taxonomy code PRV03 is required if PRV02 is present Example: PRV✽PE✽PXC✽208D00000X~
  Institutional	Header	NPI	Loop: 2310A - ATTENDING PROVIDER NAME Segment: NM1✽71 NM108: Identification Code Qualifier = XX NM109: Identification Code Qualifier = NPI NM109 is required when NM108 is available Example: NM1✽71✽1✽JONES✽JOHN✽✽✽✽XX✽1234567891~
  		Taxonomy	Loop: 2310A - ATTENDING PROVIDER SPECIALTY INFORMATION Segment: PRV PRV01: AT (Attending) PRV01 is required if PRV loop is present PRV02: PXC (Qualifier for taxonomy code) PRV02 is required if PRV01 is present PRV03: Provider taxonomy code PRV03 is required if PRV02 is present Example: PRV✽AT✽PXC✽208D00000X~

Messaging will appear on your remittance voucher to alert you of any NPI or taxonomy information that is missing or does not match your provider file.

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

Effective October 05, 2024, the Office of Workers’ Compensation Programs (OWCP) providers will have the ability to add supporting documentation using the Workers’ Compensation Medical Bill Processing (WCMBP) portal for “In Process” bills. Adding attachments before the final adjudication of the bill allows providers to provide additional information to aid in bill approval, reducing the need for adjustments.

Providers can view this option on the WCMBP portal under Bill Inquiry and then navigating to the Bill Detail page. If a bill status is “In Process,” then the View/Add Attachment button will be available at the top left of the page.

Providers can select the button to upload attachments. More than one attachment is allowed. Each attachment cannot exceed 10 MB.

Please note that if the bill has been finalized, adding attachments is no longer allowed. This error message will appear upon attempting to upload attachments: “The bill processing is complete and additional attachments cannot be added.” In this case, the provider can refer to the final bill adjudication on the Remittance Voucher to determine whether to submit an adjustment for paid or partially paid bills or to resubmit for denied bills.

Refer to the Direct Data Entry Billing Tutorial or the Bill Adjustment Tutorial for instructions and examples.

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

Effective August 24, 2024, the Office of Workers’ Compensation (OWCP) Division will enhance the Workers’ Compensation Medical Bill Processing (WCMBP) authorization submission page to better reflect when an authorization correction request has been approved.

Currently, if a correction request is approved, then the approved correction request is updated to Cancelled status, and the approved authorization changes are reflected in the original authorization request.

In the new process, if a correction request is approved, then the approved correction request will then change to Corrected status and the approved authorization changes will be reflected in the original authorization request.

The steps to submit an authorization correction request for OWCP review will remain the same. Refer to the Submitting an Authorization Correction quick reference guide (QRG) for more information.

For additional information, contact our Call Center at the applicable numbers 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

Updated versions of the OWCP-915 claimant reimbursement and DEEOIC authorization request forms are now available and have an expiration date of 07/31/2027. Please begin using the updated forms for any claimant reimbursement or DEEOIC authorization requests. Forms are available at https://owcpmed.dol.gov/portal/resources/forms-and-references/general. To access the OWCP-915, please select the respective program (DCMWC, DEEOIC, or DFEC) at the top of the Forms and References page. To access the DEEOIC authorization request forms, please select the DEEOIC program at the top of the Forms and References page.

Effective August 24, 2024, the Division of Coal Mine Workers’ Compensation (DCMWC) will initiate a recoupment process in conjunction with the Treasury Department to recover outstanding provider debts owed to the Federal Black Lung Program.

Currently, the Federal Black Lung Program automatically recoups the full amount owed from current and future provider payments until the debt is paid in full.

On or after August 24, 2024, if the debt remains unpaid after 120 days from the Remittance Voucher (RV) overpayment notice, the account balance will be sent to the Centralized Receivables Service (CRS) for collections.

If you have an inquiry or concern regarding the Remittance Voucher (RV) overpayment notice, please submit the RV overpayment notice and all supporting documentation to the following address:

Division of Coal Miner Workers’ Compensation (DCWMC)
General Correspondence
P.O. Box 8307
London, Kentucky 40742-8307

For questions, contact our Call Center at the phone 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

The Office of Workers’ Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) requires that valid surgical procedure codes be submitted for surgical package authorization requests. The valid surgical code range is 10021 – 69990.

Non-surgical procedure codes cannot be submitted on a surgical package authorization request. Mailed or faxed surgical package authorization requests submitted with non-surgical procedure codes will be returned to the provider (RTP’d).

Non-surgical procedure codes can be submitted on an alternative authorization request template, such as General Medical. Please see our Authorizations Introduction page for templates and tutorials: https://owcpmed.dol.gov/portal/Provider/Authorizations.

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

Effective July 13, 2024, the Office of Workers’ Compensation Programs (OWCP) will enhance the Workers’ Compensation Medical Bill Processing (WCMBP) eligibility inquiry and authorization submission pages with new messaging to inform users if the procedure code is covered or not covered with a certain modifier.

The eligibility inquiry messaging is applicable to the DCMWC, DEEOIC, and DFEC programs.

The authorization submission messaging is applicable to DEEOIC and DFEC.

The message will be updated to include the following scenarios:

• Procedure code and modifier combination is not covered.
• Procedure code must be submitted with modifier to be covered.
• Procedure code/modifier combination are not covered, but procedure code and other modifier combination are covered.

For additional information, contact our Call Center at the applicable numbers 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

The Division of Energy Employees Occupational Illness Compensation (DEEOIC) does not accept payments made by mail. All providers must submit an adjustment (corrected bill) to ensure that the overpayment created is properly reflected as an account receivable by DEEOIC. Once the account receivable is established, providers will receive a debt letter and instructions on how to service the account receivable from the Treasury's Centralized Receivables Service (CRS). For more information click here and refer to the section titled "How to Submit Refunds of Overpayments".

Beginning June 1, 2024, Office of Workers’ Compensation Programs (OWCP) providers can access a new Electronic Case Lookup feature on the secure Workers’ Compensation Medical Bill Processing (WCMBP) portal.

Providers will be able to enter claimant information to obtain a claimant’s OWCP case number. This feature will be available to locate the case number for DCMWC, DEEOIC, or DFEC claimants.

After selecting the Program, providers will be able to inquire by:

• Date of Birth (DOB) and Social Security Number (SSN) or
• Date of Birth (DOB), First Name, and Last Name
• Please note, in addition to the above criteria, providers must enter the Date of Injury (DOI) for DFEC claimants.

Please refer to the Verify Claimant Eligibility tutorial for further information.

For questions, contact our Call Center at the applicable phone 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 June 1, 2024, the Office of Workers’ Compensation Programs (OWCP) will implement updates for adjustment/void processing.

For the Division of Federal Employees’ Compensation (DFEC), providers will no longer be allowed to submit bill void transactions.

• Providers wishing to return funds have the option to mail the refund along with an Adjustment Request template as the coversheet.
• For assistance in viewing the PDF, please select this link: How to view PDFs using Adobe Reader

For the Division of Coal Mine Workers’ Compensation (DCMWC), providers will have the new option to submit bill adjustments using the WCMBP portal.

• You may refer to the Bill Adjustment tutorial for further information.

For the Division of Energy Employees Occupational Illness Compensation (DEEOIC), there are no changes in the current process for adjustment requests.

For questions, contact our Call Center at the applicable phone 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 June 1, 2024, the Office of Workers’ Compensation Programs (OWCP) will implement an enhancement to prevent overpayments created from denied adjustment requests. 

On or after June 1, 2024, if an adjustment is submitted on a bill that has already been paid but subsequently denied in its entirety, the denial will be reflected on the Remittance Advice (RV), and the bill inquiry screen will display a status of denied.

In such cases, when providers seek payment reconsideration for the denied bill, it is essential to submit the adjustment request using the previously paid bill. This ensures that the adjustment is correctly associated with the original bill and facilitates the review process for payment reconsideration.

Providers are encouraged to use the Bill Inquiry and Bill Adjustment features of the Workers’ Compensation Medical Bill Processing (WCMBP) Portal https://owcpmed.dol.gov/ to review bill history. 

For questions, contact our Call Center at the applicable phone 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 April 20, 2024, the Office of Workers’ Compensation Programs (OWCP) Division of Federal Employees’ Compensation (DFEC) will implement a recoupment process for providers’ outstanding debts.

Providers may have partial or full payment amounts applied to existing overpayments until the full overpaid amount is satisfied and all debts are closed.

Providers can refer to the remittance voucher (RV) for overpayment summary, recoupment summary, and recoupment details. A Remittance Voucher User Guide is available for an explanation on how to read the sections in the RV.

In addition, providers can also use the View Accounts Receivable feature after logging in to the Workers’ Compensation Medical Bill Processing (WCMBP) portal OWCP Connect (dol.gov). Providers can filter or sort results on the Accounts Receivable (AR) List to identify overpayment history, verify remaining debt balance owed, and review accounts receivable details by clicking on the AR Number.

Annual 1099s balances will be updated to reflect all recoupments.

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

Effective April 20, 2024, OWCP will release a new Fee Schedule Calculator tool on the Workers’ Compensation Medical Bill Processing (WCMBP) web portal https://owcpmed.dol.gov/portal/. This feature will be available to providers after logging in to the secure WCMBP portal.

The fee schedule calculator is a tool used to estimate the maximum allowable amount for services rendered and billed on the OWCP 1500 Professional form or the ADA Dental form. It is important to note:

• While the fee schedule calculator tool estimates payment, it does not guarantee eligibility or coverage for your specific service.
• The fee schedule calculator tool will not advise if services are appropriate for the accepted condition and will not confirm if authorization is required. Please use the Claimant Eligibility Inquiry and Authorization Submission features to verify this information.

Please refer to the Fee Schedule Calculator Quick Reference Guide for step-by-step instructions.

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

Effective April 20, 2024, providers can select an option to receive outbound OWCP medical bill processing correspondence electronically only. Electronic copies can be accessed on the secure WCMBP Portal (https://owcpmed.dol.gov/portal/).

The paperless option includes correspondence such as Remittance Vouchers (RV), Authorization Approval Letters, and Billing Returned To Provider (RTP) Letters.

Providers can select the paperless option in the Add Location step of a provider enrollment application or the Provider Maintenance page by selecting the “opt in” checkbox. A contact email address will be required, as providers will receive an email notification notifying that correspondence is available on the WCMBP Portal

Provider Enrollment and IRS correspondence will continue to be mailed in addition to being available electronically on the portal. This includes 1099s, Provider Enrollment Welcome Packets, and Provider Enrollment RTPs.

For additional information, contact our Call Center at the applicable phone 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