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 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 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".

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 December 9, 2023, the DFEC Program for Office of Workers’ Compensation Programs (OWCP) will enhance bill processing to automatically reprocess previously submitted bills that denied when the injured or ill worker’s case was under development, after the case is later accepted as payable by OWCP.

On December 9, 2023, a one-time courtesy bill reprocessing will occur for claimant cases that were adjudicated by DFEC, and accepted conditions assigned in the previous four weeks.

Afterwards, bills denied after December 9, 2023, will be automatically reprocessed if the case is accepted as payable.

Please note that additional denial EOBs may post during reprocessing. For example, if denials post for authorization of services related to accepted conditions, then providers are encouraged to request authorization for the billed service(s).

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

Effective July 15, 2023, the Office of Workers’ Compensation (OWCP) Division of Federal Employees’ Compensation (DFEC) Program is implementing a new utilization review (UR) for hearing aid services and supplies.

Please refer to the FECA Circular NO. 23-08 for more information. FECA Circulars | U.S. Department of Labor (dol.gov)

New limits have been defined for DFEC hearing aid supplies and services.

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

Effective June 24, 2023, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) will enhance the bill processing of durable medical equipment (DME) supplies and accessories.

A separate DEEOIC Durable Medical Equipment (DME) supplies and accessories authorization is not required for the following conditions:

• A rental authorization is approved and on file for the related DME, and service dates are within the rental period.
• A purchase authorization is approved and on file for the related DME, and service dates are within three (3) years of the purchase period.

Providers will not need to submit a correction to an existing DME authorization for the associated supplies or accessories if an approved authorization is on file.

In addition, new utilization limits are added to restrict certain DME codes for DEEOIC.

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