The Centers for Medicare & Medicaid Services (CMS) released Change Request 8999, to advise providers of the 2015 annual update for the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule.
For 2015, the update factor of 1.5 percent is applied to the applicable 2014 DMEPOS fee schedule amounts. The labor payment rates for L-4205 (ortho dvc repair per 15 min) and L-7520 (repair prosthesis per 15 min) are also updated by a factor of 2.1 percent.
CMS is also adjusting the fee schedule amounts for shoe modification codes A-5503 (diabetic shoe w/roller/rockr); A-5504 (diabetic shoe with wedge); A-5505 (diab shoe w/metatarsal bar); A-5506 (diabetic shoe w/off set heel); and A-5507 (modification diabetic shoe) in order to reflect more current allowed service data. Section 1833(o)(2)(C) of the Act required that the payment amounts for shoe modification codes A-5503 through A-5507 be established in a manner that prevented a net increase in expenditures when substituting these items for therapeutic shoe insert codes A-5512 (multi den insert direct form) or A-5513 (multi den insert custom mold). For 2015, CMS is updating the weighted average insert fees used to establish the fee schedule amounts for the shoe modification codes with more current allowed service data for each insert code. The base fees for A-5512 and A-5513 will be weighted based on the approximated total allowed services for each code for items furnished during the calendar year 2013.
The effective date of these changes is January 1.
