The Office of Inspector General (OIG) has again recommended that Medicare review its allowable amounts for Healthcare Common Procedure Coding System (HCPCS) codes for 161 orthotic devices. The recommendation was first made in 2019. The report says the agency and its beneficiaries have paid an estimated $337.5 million more for the codes than they have for payers outside of Medicare.
The OIG is responsible for oversight of the approximately $2.4 trillion portfolio of programs of the Department of Health and Human Services (HHS). The OIG and HHS developed a public-facing page for tracking all of its recommendations, and the orthotics codes are included in the report called “Top Unimplemented Recommendations.”
The OIG also recommended that Medicare adjust the allowable amounts, as appropriate, using existing regulations or seek legislative authority to align Medicare allowable amounts for these items with payments made by the select nonMedicare payers.
To read the report, visit the OIG’s Recommendations Tracker.
