In June, the Centers for Medicare & Medicaid Services (CMS) is issuing a Comparative Billing Report (CBR) on Medicare Part B claims for orthoses referring provider. The report, CBR202206, summarizes statistics for providers listed as referring providers and services with dates of service for the full year 2021 for off-the-shelf and custom-fitted prefabricated orthoses. The data-driven report can be used to compare billing practices by state and nationwide.
The Healthcare Common Procedure Coding System (HCPCS) codes in the report are L-0642, L-0648, L-0650, L-1820, L-1833, L-1851, L-1971, L-2397, L-3170, L-3660, L-3760, L-3761, L-3908, L-3916, and L-3960.
Nationwide, 110,796 referring providers were listed on claims for the target codes. Over $207 million was paid for the claims. A CBR is presented to a provider when the analysis of their billing patterns differs from the provider’s peers on a state, specialty, and/or a nationwide level.
CBRs aren’t publicly available but access will be sent by email from [email protected] to providers’ email addresses on file in PECOS.