ePACES. Workers Comp Bill Proc. Portal. Effective May 1, 2014, the Office of Workers' Compensation Programs (OWCP) will begin calculating the maximum allowable fee for pharmacy billings of prescription drugs using a different formula which differentiates between brand name drugs and generic drugs.
The maximum allowable fee for brand name drugs will be 90% of the AWP plus a $4.00 dispensing fee, and the maximum allowable fee for generic drugs will be 75% of the AWP plus a $4.00 dispensing fee. This change will affect prescriptions paid under all of the OWCP Programs; Division of Federal Employees' Compensation Act (DFEC), Division of Energy Employees' Occupational Illness Compensation (DEEOIC), Division of Coal Mine Workers Compensation (DCMWC). The Office of Workers' Compensation Programs (OWCP) will adopt the use of the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10) on a schedule aligned with the Centers for Medicare & Medicaid Services (CMS).
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