CMS has released the 2014 Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule, which will be implemented for claims with a date of service on or after Jan. 1, 2014.
According to a press release from the American Orthotic & Prosthetic Association (AOPA), existing Medicare fees for Healthcare Common Procedure Coding System (HCPCS) codes that describe orthotic and prosthetic devices have been increased by 1%, reflecting the 1.8% Consumer Price Index-Urban All Item annual update minus the 08% annual productivity adjustment for 2014.
Fee schedule amounts for 23 new HCPCS codes were created to describe off-the-shelf (OTS) orthoses, as well as HCPCS codes whose descriptors were changed to indicate that they are either OTS or are required to be “trimmed, bent, molded, assembled or otherwise customized to fit a specific patient by an individual with expertise.” The fee schedule for these codes are the same whether they are classified as OTS or require specific fitting.
Although the fee schedule is subject to change, it does not appear to include a reduction in reimbursement for the HCPCS codes that describe OTS orthoses, according to AOPA.
The 2014 Medicare DMEPOS fee schedule may be downloaded from the AOPA website. For more information, email Joe McTernan at jmcternan@aopa.org or Devon Bernard at dbernard@aopanet.org.