During peak call volume times (Monday - Friday 11a-6p EST), the wait times to speak to a Customer Service Team Member can be rather long. Instead of waiting on the phone, you can call our Interactive Voice Response System (IVRS) or access the OWCP Web Bill Processing Portal to receive the same information that you're likely calling our Customer Service Team about. When accessing either of these systems, you will receive the same detailed and current information as if you were speaking to a live Customer Service Team Member. There will be no loss in the continuity or integrity of information received, and both systems are available 24 hours a day, 7 days a week, every day of the year (except during times of scheduled maintenance).

To access the IVRS system, please dial (866) 335-8319 and select option '1' from the main menu. This service is available for FECA Providers, Claimants, and Agency representatives.

To access the OWCP Web Bill Processing Portal, go to https://owcpmed.dol.gov.This website is available for Providers and Claimants. (Providers will need to self-register for access. Claimants just need to provide some identifying information to view their case details.)

Effective April 18, 2020, online medical bill and authorization requests, including Contract Nurse and Voc. Rehab. services, will not be available through Conduent. On April 27, 2020, online medical bill and authorization submission will be available through CNSI's portal when all medical bill processing services transfer to OWCP's new bill pay contractor, CNSI. Please refer to https://prod.wcmbp.com/outreach for further information.

Starting April 27, 2020, the Office of Workers' Compensation Programs (OWCP) will transfer all medical bill processing services to OWCP's new bill pay contractor, CNSI. On March 16, 2020, please refer to https://prod.wcmbp.com/outreach for information pertaining to the transition. This link will be available until April 24, 2020.

Conduent will only provide OWCP pharmacy bill processing services and will be utilizing a new web address URL (https://owcprx.dol.gov) and new mailing address.

Please submit your OWCP pharmacy related bills and pharmacy correspondence to the following new PO Boxes

DFEC Pharmacy bills should be mailed to:
Department of Labor Pharmacy Bill Processing, DFEC
PO Box 8308
London, KY 40742-8308

DCMWC Pharmacy bills should be mailed to:
Department of Labor Pharmacy Bill Processing, DCMWC
PO Box 8309
London, KY 40742-8309

DEEOIC Pharmacy bills should be mailed to:
Department of Labor Pharmacy Bill Processing, DEEOIC
PO Box 8310
London, KY 40742-8310


Effective immediately, OWCP Pharmacy providers should begin using the new PO Boxes. We highly recommend transitioning to the new PO Box addresses as soon as possible. Any submitted pharmacy provider bills/correspondence sent to the old DOL Central Mailroom PO Boxes, after 04/17/2020, will be returned unprocessed.

Please be advised that for Tax Year 2019 and thereafter a single Form 1099-MISC will be issued per Tax ID Number (TIN) for OWCP medical benefit payments. In addition, TINs with only pharmacy providers enrolled will no longer be receiving Form 1099-MISC per the Form 1099-MISC instructions. If the TIN has multiple provider types enrolled, including pharmacy, a Form 1099-MISC will be issued which will account for each enrolled provider's medical benefit payments.
If you have questions or concerns please contact OWCP's bill processing contractor, Conduent, at 1-844-493-1966.

On June 14, 2018, the Office of Workers' Compensation Programs' Division of Coal Mine Workers' Compensation issued a final rule governing the Black Lung Disability Trust Fund's payment of medical benefits under the Black Lung Benefits Act. The final rule adopted payment formulas that accurately reflect prevailing community rates for authorized treatments and services. Most of the revised regulations applied from August 31, 2018, the effective date of the rule. However, the regulations governing payment of professional medical services and outpatient medical services had a later applicability date of November 30, 2019, so that a new computer system could be developed to process these bills. OWCP is delaying the applicability date of the regulations governing payments for professional medical services and hospital outpatient services from November 30, 2019 to April 26, 2020, due to unforeseen delays in developing the computer system. More information is available at: https://www.dol.gov/owcp/dcmwc/.

Beginning on September 22, 2019, the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) is limiting newly prescribed opioid users (i.e. where an opioid has not been prescribed within the past 180 days, if ever) to an initial 7-day supply for all opioids. An injured worker may receive a maximum of four sequential 7-day supply prescriptions (an initial and three subsequent prescriptions), a total of 28 days, before prior authorization is required. During the initial 28-day period, each sequential prescription could be for a different opioid but no more than one opioid may be prescribed at any given time without prior approval from DFEC. For consideration of any opioid authorization past the 28 day period, the prescribing physician must complete a form CA-27 Letter of Medical Necessity that must be reviewed and approved by DFEC before the opioid medication can be authorized and dispensed. The prescriber may complete the form no sooner than 9 days prior to the end of the 28-day period. All subsequent opioid prescriptions will be subject to the LMN requirement, which will authorize up to 60 days of additional opioid use, with fills to be issued in no more than 30-day supplies. For additional information, please see the DFEC website at https://www.dol.gov/owcp/dfec/ for further information under the "Latest News" section.

A regulatory change to the EEOICPA Final Rule was published on February 8, 2019, and went into effect April 9, 2019. This change made OMB forms EE-17A and EE-17B required for initiating initial (claimant has never received services through EEOICPA) authorization requests for home health care, hospice, assisted living, and nursing home care. Upon implementation of the forms on June 3, 2019, medical providers will no longer submit authorization request forms to Conduent to initiate care for the aforementioned service types when the claimant requests care for the first time. However, the authorization details (approved, denied, or pending) concerning these requests will continue to be processed and transmitted to Conduent. All emergency temporary authorization requests, or requests for reauthorization, or requests for an amended level of care will continue to be submitted to Conduent using the existing processes.

To review the EE-17A and EE-17B forms click here.

Effective April 25, 2019, The Division of Energy Employees Occupational Illness Compensation (DEEOIC) released a new policy regarding Targeted Case Management (TCM). TCM authorization requests submitted prior to April 25, 2019, are not impacted by the new policy.

Targeted Case Management (TCM) can occur when a claimant is prescribed multiple types or levels of care related to their covered condition(s). TCM is the coordination of different care providers (such a Home Health Aids, RNs, Therapists, etc.), and the different treatments being provided to assure that the medical care is appropriately scheduled, and that treatments don't inappropriately overlap or have unintended negative impacts on the claimant's health. This process facilitates services provided and assists claimants in gaining access to needed medical, social, educational, and other services directly related to their DEEOIC accepted condition(s).

DEEOIC does not reimburse for the supervision and monitoring of staff by RNs or other higher credentialed individuals. DEEOIC considers the supervision of home health care staff to be the inherent responsibility of the medical provider that the claimant chooses to provide health care services. The training or continuing education of health care personnel is also not considered TCM or reimbursed.

For more information, click here.

Beginning June 1, 2019, in accordance with the discretion granted to DOL and delegated to the Office of Workers' Compensation Programs (OWCP), the Division of Federal Employees' Compensation (DFEC) 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 FECA CIRCULAR 19-07, which can be found on the DFEC website at
https://www.dol.gov/owcp/dfec/medicalprovider.htm.

Beginning February 22, 2019, in accordance with the discretion granted to DOL and delegated to the Office of Workers' Compensation Programs (OWCP), the Division of Federal Employees' Compensation (DFEC) is instituting a new policy to deny payment of a select group of FDA Medical Devices. The list of items to be denied will be identified by National Drug Code (NDC). Any bill identified as containing a charge for any such non-covered NDC will be denied in its entirety. A listing of non-payable NDCs will be available on DFEC's website at https://www.dol.gov/owcp/dfec/.

PRESCRIPTIONS The Department of Labor's Office of Workers' Compensation Programs Division of Federal Employees' Compensation (OWCP DFEC) has contracted with First Script to serve as DFEC's Pharmacy Benefit Manager (PBM) for claimants covered under the Federal Employees' Compensation Act (FECA). First Script/FECA pharmacy cards and welcome letters will be mailed to FECA claimant in a phased approach. On January 3, 2019, welcome packets were mailed to claimants who have been prescribed opioid medication(s) with daily dosages exceeding the 90 MED (Morphine Equivalent Dose) due to urgent safety concerns. Use of the First Script/FECA pharmacy program is mandatory for FECA claimants; otherwise, payment of drugs cannot be authorized at the pharmacy..

In order to fill a prescription, FECA claimants should present the cards enclosed in the welcome packets to a participating pharmacy along with a prescriptions for an accepted FECA work-related injury. FECA claimants can search for participating pharmacies on the web at www.feca-pbm.dol.gov. When filling work-related injury prescriptions, generic medications are generally used as a more affordable alternative to brand name drugs unless the claimant's physician has otherwise indicated. First Script will assist in transitioning a FECA claimant's retail pharmacy prescriptions to their voluntary mail order program. FECA claimants should contact First Script at 877-344-3811 for complete assistance with any questions related to the First Script/FECA PBM.

DURABLE MEDICAL EQUIPMENT Use of First Script/FECA for durable medical equipment, medical supplies, and ancillary services is voluntary. United States Postal Service (USPS) employees/claimants seeking durable medical equipment, medical supplies, and ancillary services should contact the USPS directly to obtain additional information on how to obtain these services.

On June 14, 2018, the Office of Workers' Compensation Programs Division of Coal Mine Workers' Compensation issued a final rule governing the Black Lung Disability Trust Fund's payment of medical benefits under the Black Lung Benefits Act. The final rule adopts modern payment formulas for physicians, hospitals and other providers; codifies the black lung program's current practices for payment of prescription drugs and the submission of medical bills for payment; provides greater clarity about fees paid to providers; and prohibits providers from seeking additional payments from miners for covered services that have been paid by the Trust Fund. The regulations will be effective August 31, 2018. Rules governing payment of professional medical services and outpatient medical services have a delayed application date and will apply to services rendered after November 30, 2019. More information is available at: https://www.dol.gov/owcp/dcmwc/

Effective 5/22/2018, providers may notice a change in the timing of viewable pending authorizations regarding home health care services upon logging into the web bill processing portal. This change is the result of a system enhancement to improve electronic communications between Conduent and DEEOIC. A "Pending" status will indicate that the request is under review by a Medical Benefits Examiner (MBE). Subsequent determination (Approval/Denial) will follow as appropriate. For the status of an emergent care request, providers may continue to contact Conduent's Customer Service or the respective Medical Benefits Examiner as applicable.

Beginning June 1, 2018, payment for medications billed under these codes will require prior authorization by DFEC claims staff. A strict exception based policy is described in FECA CIRCULAR 18-06, which can be found on the DFEC website at https://www.dol.gov/owcp/dfec/medicalprovider.htm. Prior authorization may be requested by utilizing the Unspecified J Code Authorization Request, which is available at https://owcpmed.dol.gov . This is the only method available for requesting prior authorization. Bills for these codes received on and after June 1, 2018 without prior authorization will deny.

Effective June 11, 2018, T1001 will no longer require prior authorization. T1001 is the HCPCS billing code utilized to identify an assessment/evaluation conducted by a nurse. Providers will still be required to submit the treating physician's prescription and/or Letter of Medical Necessity along with the nurse's assessment report with their claims upon billing for services rendered.

Beginning February 28, 2018, in accordance with the discretion granted to DOL and delegated to the Office of Workers' Compensation Programs (OWCP), the Division of Federal Employees' Compensation (DFEC) is instituting a new policy to deny payment of a select group of Pharmaceutical and Non-Pharmaceutical items. The list of items to be denied will be identified by National Drug Code (NDC) and includes, but is not limited to, convenience kits. Any bill identified as containing a charge for any such non-covered NDC will be denied in its entirety. A listing of non-payable NDCs will be available on DFEC's website at https://www.dol.gov/owcp/dfec/.

Effective January 16, 2018, the Division of Energy Employees Occupational Illness Compensation Program (DEEOICP) is changing how it evaluates requests for Physical therapy, Occupational therapy, Speech therapy, and other rehabilitative therapy services. A DEEOIC Policy Bulletin has been published that explains the changes in more detail. The Bulletin includes guidance relating to initial therapy assessments, medical evidence necessary to support requests, maximum levels of coverage and locations where therapy can occur. Requests for rehabilitative therapy authorization may continue to be faxed to 800-882-6147.

Effective December 31, 2017, the URL address https://owcp.dol.acs-inc.com will no longer be valid for access to the Web Bill Processing Portal. The new URL address will be https://owcpmed.dol.gov

Effective August 1, 2017, email addresses ending with @xerox.com will no longer be valid for contacting Conduent. Conduent email addresses end in @conduent.com.

Effective May 1, 2017, Enteral Formula (Nutritional Supplements) now requires prior authorization. Enteral formulas are liquid preparations used for nutritional supplementation or replacement in patients who are unable to obtain adequate nutrition through their regular diet. These formulas are taken by mouth or through a feeding tube, and are used by the body for energy and to form substances needed for normal bodily functions. Failure to obtain prior authorization may delay reimbursement or result in a denial. Please click here to review this update.

Beginning in August 2017, the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) will require claims with newly prescribed opioid use (i.e. claims where an opioid has not been prescribed within the past 180 days, if ever) to have a completed and approved Letter of Medical Necessity (LMN) form on file for prescription authorizations after an initial 60 day period. Additionally, compounded medications containing opioids will require a completed and approved LMN prior to dispensing, effective June 26, 2017. This form will be made available to registered providers beginning in June 2017 at https://owcpmed.dol.gov/portal/main.do. To submit the form, providers must click on the 'Provider' Link to the right of the FECA oval located at the top left of the home page, login with their user ID and password, and then click on the 'LMN Documents' link located in the left menu bar. For providers not yet registered, after clicking the 'Provider' link, click the 'Web Registration' link located in the left menu bar to register for web access. For providers not yet enrolled, click on 'Forms & Links' in the horizontal menu at the top of the home page to download the Provider Enrollment form and instructions. Authorizations for opioid medications will be limited to a maximum of 60 days, with initial fills and refills to be issued in no more than 30-day supplies. Beneficiaries already receiving opioid prescriptions will not be subject to the LMN requirement at this time. For additional information, please see the DFEC website at https://www.dol.gov/owcp/dfec/ for further information under the "Latest News" section.

Beginning May 2017, in accordance with the discretion granted to DOL and delegated to the Office of Workers' Compensation Programs (OWCP), the Division of Federal Employees' Compensation (DFEC) is instituting a new policy on filling non-maintenance medications for the treatment of work-related injury or illness. The program's policy will limit the fill of non-maintenance medications to 30 day increments. Additionally, refills cannot be obtained until 75% of the prescription timeline has passed. Maintenance medications (such as those used to treat chronic conditions like high blood pressure and asthma) will not be subject to these limitations. In determining what constitutes a maintenance medication, DFEC will be relying primarily on First Data Bank classifications. Physicians seeking to have the 30 day/75% fill requirement waived for non-maintenance drugs should submit a written request directly to the responsible DFEC district office because there is no method of requesting an exception through the Web Bill Processing Portal. Waiver of the fill requirements for non-maintenance drugs will be authorized on an exception basis only based on approval of the OWCP Chief Medical Officer or his/her designee.

Beginning March, 2017, in accordance with the discretion granted to DOL and delegated to the Office of Workers' Compensation Programs (OWCP), the Division of Federal Employees' Compensation (DFEC) is instituting a new policy for authorizing herbal supplements prescribed by physicians for treatment of work-related injuries or diseases. The Program's policy will be to not authorize payment for herbal supplements, unless a claimant's treating physician acquires prior authorization by submitting rationalized medical evidence that supports the herbal supplement's safety, effectiveness, and necessity. To implement this policy, OWCP will rely primarily on First DataBank (FDB) classification. Physicians wishing prior authorization for an herbal supplement should submit a written request directly to the responsible District Office as there is no form or other provision for authorization to be requested through the Web Bill Processing Portal. Herbal supplements are authorized only on an exception basis on approval of the OWCP Chief Medical Officer or his/her designee. For more information, please visit the DFEC website:
https://www.dol.gov/owcp/dfec/PolicyOnHerbalSupplements.htm

Beginning in October 2016, the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) will require all claims for prescription medications which contain a compounded drug to have a completed and approved Letter of Medical Necessity (LMN) on file for prescription authorizations submitted starting in early October. This form will be made available to registered providers beginning in October 2016 at https://owcpmed.dol.gov/portal/main.do.
To submit the form, providers must click on the 'Provider' Link to the right of the FECA oval located at the top left of the home page, login with their user ID and password, and then click on the 'LMN Documents' link located in the left menu bar. For providers not yet registered, after clicking the 'Provider' link, click the 'Web Registration' link located in the left menu bar to register for web access. For providers not yet enrolled, click on 'Forms & Links' in the horizontal menu at the top of the home page to download the Provider Enrollment form and instructions. Authorizations for compounded drug prescriptions will be limited to a maximum of 90 days, with initial fills and refills to be issued in 30 day supplies.

Effective September 25, 2016, TENs Unit Supplies are no longer billable as individual services and must be billed under HCPCS code A4595 (Electrical stimulator supplies, 2 leads, per month). This allowance includes: electrodes (any type), conductive paste or gel, tape or other adhesive, adhesive remover, skin preparation materials, and batteries (9 volt or AA, single use or rechargeable), and a battery charger (if rechargeable batteries are used). If 2 leads are medically necessary, a maximum of only one unit will be allowed per month for Procedure Code A4595. If 4 leads are medically necessary, a maximum of two units will be allowed per month. The following HCPCs codes are no longer covered as separately billable services; A4365, A4450, A4452, A4455 A4456, A4558, A4630, A5120, A5126, and A6250. All TENs unit supplies must be billed using HCPCS Procedure Code A4595.

Generic Medications: For services billed on or after July 1, 2016, the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) will calculate the maximum allowable fee for generic drugs at 60% of the average wholesale price (AWP) plus a $4.00 dispensing fee.
Compound Medications: For services billed on or after July 1, 2016, the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) will calculate the maximum allowable fee at:

• 50% of AWP of each NDC in the compounded drug, for compounded drugs containing three or fewer ingredients
• 30% of AWP of each NDC in the compounded drugs, for compounded drugs containing four or more ingredients

Effective July 1, 2016, the initial prescriptions for compound medication should be for a period not to exceed 90 days. Initial prescriptions for periods greater than 90-days may be subject to further review for medical necessity.

Effective October 1, 2015, OWCP will only accept paper bills submitted on the newest version of the dental claim form (2012 American Dental Association J430D).
Any bill submitted on an older version of the dental claim form will be returned to the provider and will not be submitted for processing. Additionally, all claims submitted on the new form must include the diagnosis code(s) for treatment (box 34a), a diagnosis pointer for each line billed (box 29a), and the appropriate diagnosis code list qualifier (box 34), regardless of the date the service was provided.

Starting October 1, 2015, reimbursement for out of pocket expenses, such as qualified medical bills and medical travel expenses, is available for deposit directly into your checking or savings account. Electronic Funds Transfer(EFT) is a much faster and more secure way to receive reimbursement compared to paper checks. We strongly encourage DEEOIC beneficiaries to select EFT as the preferred payment method. To obtain the DIRECT DEPOSIT SIGN UP FORM click here.

Important information for Energy Employees Occupational Illness Compensation Program medical providers is now available click here.

Important information about the new Energy Employees Occupational Illness Compensation Program Medical Benefits Identification Card is now available.
Providers - click here:
Claimants - click here:

Effective October 1, 2015 Physicians must specify the laterality of a claimant's condition as applicable (e.g. right or left upper extremity, right or left kidney, right or left lung, etc initial encounter) in their medical documents and medical bills in order for a bill not to be denied.

Effective August 31, 2015, The Office of Workers' Compensation Programs (OWCP) will no longer accept paper bills submitted on the UB92 Form. Bills submitted on the UB92 form will be returned to the provider with a letter of explanation indicating: "Incorrect Form - Submit on the proper form. Inpatient/Outpatient - Submit on UB04."

Your providers will continue to use ICD-9 codes for services provided before October 1, 2015. ICD-10 codes are required by your provider for services provided on or after October 1, 2015.

Effective October 1, 2015, OWCP will only accept paper bills submitted on the newest version of the dental claim form (2012 American Dental Association J430D). Any bills submitted on an older version of the dental claim form will be returned to the provider and will not be submitted for processing.

Effective February 01, 2015 the Office of Workers' Compensation Programs (OWCP) Division of Federal Employees' Compensation (DFEC) will no longer accept CPT code 99070 when the service is billed by a licensed DME provider. If a DME provider submits a bill for DME services utilizing the procedure code 99070, the service will be denied.

Effective March 22, 2015, the Office of Workers' Compensation Programs (OWCP): Division of Federal Employees' Compensation (DFEC) and Division of Energy Employees Occupational Illness Compensation (DEEOIC) will require the NPI number in Block J on the CMS1500/OWCP1500 form for all surgical procedure codes. If the NPI number is missing, the line will be denied. If multiple providers participated in the surgery, supporting documentation must be submitted.

Subscribe to DEEOIC Medical Provider Updates via Email (click here)

Effective February 22nd, 2015, the Office of Workers' Compensation Programs (OWCP), Division of Energy Employees Occupational Illness Compensation (DEEOIC) will implement a new reimbursement methodology which will be based on the Medicare Outpatient Prospective Payment System (OPPS). The new payment method will utilize Medicare’s Ambulatory Payment Classifications (APC) as well as the OWCP fee schedule.

The new payment method will apply to outpatient care in all acute care hospitals including general hospitals, freestanding rehabilitation hospitals and long-term care hospitals, with the exception of critical access hospitals and Maryland hospitals. When submitting the OWCP-04 form for Outpatient services, providers will be required to enter their Medicare Number in box 51. If the Medicare number is missing or invalid, the bill will be denied.

Effective January 2, 2015 the customer service number for questions related to provider enrollment, FECA bill payment, and FECA medical authorization status is changing to a new Toll Free Number from
(850) 558-1818 to (844) 493-1966.


Re-Enrollment Announcement

FECA users can access the Interactive Voice Response System (IVRS) to utilize bill status inquiry, claimant eligibility inquiry, and medical authorization inquiry functionality 24 hours a day. To access the IVRS system, please dial (866) 335-8319 and select option '1' from the main menu.

Provider Outreach Presentation.
Provider Outreach FAQ.
Provider Outreach Presentation (Spanish).
FECA Claimant Outreach Presentation.
FECA Claimant Outreach FAQ.