Federal Employees Program

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The Federal Employees Program periodically provides medical providers with information about the FECA program on topics to include medical authorization and bill processing procedures, as well as eligibility for medical services. To receive these updates by email, please sign up for email alerts here.

Medical Authorization and Billing

*NEW – The OWCP Provider Manual is now available with important information on billing, authorizations, enrollment, policies, and eLearning training sessions.

**NEWHelpful Hints for Medical Providers – Overview of features, references, and resources available for our medical providers.

***NEW - Caring for a Federal Injured Worker with an Accepted Claim – Helpful information for medical providers caring for injured federal workers.

Mail bills for Federal workers’ compensation claims to PO Box 8300, London, KY 40742-8300.

To speak to a customer service representative about bills or authorizations, call 1-844-493-1966, (8am to 8pm Eastern Time).

More information is available on the Provider Home page of the OWCP Medical Bill Processing Portal.

Medical Authorization and Bill Processing  Information on the process for submitting medical authorization requests and bill.

Medical Authorization/Bill Pay Web Portal  A link to access OWCP's web bill processing portal, where medical providers may enroll to treat injured federal employees, check eligibility for services, submit medical authorization requests and bills, and view authorization and bill status.

Medical Authorization/Bill Pay FAQs for Medical Providers  Answers to frequently asked questions about medical authorization and bill payment.

OWCP Medical Fee Schedule  Information on the fee schedule which applies to medical bills submitted to OWCP, with a link to view the schedule.

Federal Employees Program List of Not Covered National Drug Codes (NDCs)   List of NDCs not covered, as outlined in Circulars 18-05 and 19-05, with effective dates.

Suspended and Debarred Medical Providers – Lists of medical providers that have been suspended or debarred from receiving payments under the Federal Employees' Compensation Act.

Physician Dispensed Medication using Unspecified "J Codes" Payment for medications billed under J3490, J3590, J7999, J8499, J8999 and J9999 require prior authorization by claims staff. The strict exception based policy is described in Circular 18-06. Bills for these codes received on and after June 1, 2018 without prior authorization will deny.

Current Procedural Terminology Code (CPT) 99070 Bill Payment Restrictions - Beginning June 1, 2019, Federal Employees Program will no longer recognize CPT code 99070 as a valid reimbursable code. For reimbursement of covered supplies, materials, and medication, an appropriate Level II HCPCS code must be submitted. This policy is described in CIRCULAR 19-07. Bills for these codes received on and after June 1, 2019 will deny.

 

Information on Federal Employees Program Procedures

A.M.A. Guides to Impairment, 6th Edition  A description of the method used by the Federal Employees Program to determine permanent impairment for the payment of schedule awards.

Medical (FECA Part 3) — Part 3 of the Federal Employees Program Procedure Manual, which addresses medical services and supplies and describes how medical examinations are arranged and the kinds of information medical reports should contain.

Benefit Payments (FECA Part 5) — Part 5 of the Federal Employees Program Procedure Manual which governs adjudication and payment of medical bills under the FECA.

OWCP Policy Announcements

The following announcements contain information on OWCP policy pertaining to authorization and payment of specific medical procedures and services:

New Telemedicine Guidelines for OWCP-FECA

New Opioid Prescribing Guidelines

Update on FECA's Opioid Policy

New FECA Policy on Opioid Medications

Prescriber NPI Requirement

New Policy on Filling Non-maintenance Medications

Policy on Herbal Supplements

Additional Information on Compounded Drug Medications

Billing for TENS Unit Supplies

Compounded Drug Medications

Transition to ICD-10

CPT Code 99070 Guidance

Change to Outpatient Payment Method - (Outpatient Prospective Payment System - OPPS)

Pharmacy Fee Schedule

ICD-10

Injection Service Limitations

Discontinued DOL Procedure Codes

Global Surgery

Pharmacy Processing

Automated Adjustment Process

Consultation Codes

Pharmacy Schedule II Policy

Anesthesia Fee Schedule

RP100

Schedule II Drug Program Changes for FECA