Reimbursement Info
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Reimbursement info
DME Billing Documents
Information regarding the reimbursement of our DME products
PDAC
Reimbursement by State
LCD Information
Reimbursement by State
- AK $80.25
- AL $82.69
- AR $82.68
- AZ $80.25
- CA $80.25
- CO $83.29
- CT $80.25
- DC $80.25
- DE $80.25
- FL $82.69
- GA $82.69
- HI $80.25
- IA $81.84
- ID $80.25
- IL $82.24
- IN $82.24
- KS $81.84
- KY $82.69
- LA $82.68
- MA $80.25
- MD $80.25
- ME $80.25
- MI $82.24
- MN $82.24
- MO $81.84
- MS $82.69
- MT $83.29
- NC $82.69
- ND $83.29
- NE $81.84
- NH $80.25
- NJ $80.25
- NM $82.68
- NV $80.25
- NY $80.25
- OH $82.24
- OK $82.68
- OR $80.25
- PA $80.25
- PR $88.28
- RI $80.25
- SC $82.69
- SD $83.29
- TN $82.69
- TX $82.68
- UT $83.29
- VA $80.25
- VI $88.28
- VT $80.25
- WA $80.25
- WI $82.24
- WV $80.25
- WY $83.29
- AK $423.29
- AL $436.04
- AR $436.00
- AZ $423.29
- CA $423.29
- CO $439.29
- CT $423.29
- DC $423.29
- DE $423.29
- FL $436.04
- GA $436.04
- HI $423.29
- IA $431.54
- ID $423.29
- IL $433.63
- IN $433.63
- KS $431.54
- KY $436.04
- LA $436.00
- MA $423.29
- MD $423.29
- ME $423.29
- MI $433.63
- MN $433.63
- MO $431.54
- MS $436.04
- MT $439.29
- NC $436.04
- ND $439.29
- NE $431.54
- NH $423.29
- NJ $423.29
- NM $436.00
- NV $423.29
- NY $423.29
- OH $433.63
- OK $436.00
- OR $423.29
- PA $423.29
- PR $465.60
- RI $423.29
- SC $436.04
- SD $439.29
- TN $436.04
- TX $436.00
- UT $439.29
- VA $423.29
- VI $465.60
- VT $423.29
- WA $423.29
- WI $433.63
- WV $423.29
- WY $439.29
- AK $1,057.10
- AL $1,088.93
- AR $1,088.86
- AZ $1,057.10
- CA $1,057.10
- CO $1,097.12
- CT $1,057.10
- DC $1,057.10
- DE $1,057.10
- FL $1,088.93
- GA $1,088.93
- HI $1,057.10
- IA $1,077.76
- ID $1,057.10
- IL $1,083.04
- IN $1,083.04
- KS $1,077.76
- KY $1,088.93
- LA $1,088.86
- MA $1,057.10
- MD $1,057.10
- ME $1,057.10
- MI $1,083.04
- MN $1,083.04
- MO $1,077.76
- MS $1,088.93
- MT $1,097.12
- NC $1,088.93
- ND $1,097.12
- NE $1,077.76
- NH $1,057.10
- NJ $1,057.10
- NM $1,088.86
- NV $1,057.10
- NY $1,057.10
- OH $1,083.04
- OK $1,088.86
- OR $1,057.10
- PA $1,057.10
- PR $1,162.77
- RI $1,057.10
- SC $1,088.93
- SD $1,097.12
- TN $1,088.93
- TX $1,088.86
- UT $1,097.12
- VA $1,057.10
- VI $1,162.77
- VT $1,057.10
- WA $1,057.10
- WI $1,083.04
- WV $1,057.10
- WY $1,097.12
- AK $1,276.57
- AL $1,444.03
- AR $1,288.57
- AZ $1,245.81
- CA $1,245.81
- CO $1,106.22
- CT $1,205.74
- DC $1,106.22
- DE $1,106.22
- FL $1,444.03
- GA $1,444.03
- HI $1,365.03
- IA $1,250.40
- ID $1,157.38
- IL $1,366.79
- IN $1,366.79
- KS $1,250.40
- KY $1,444.03
- LA $1,288.57
- MA $1,205.74
- MD $1,106.22
- ME $1,205.74
- MI $1,366.79
- MN $1,366.79
- MO $1,250.40
- MS $1,444.03
- MT $1,106.22
- NC $1,444.03
- ND $1,106.22
- NE $1,250.40
- NH $1,205.74
- NJ $1,106.22
- NM $1,288.57
- NV $1,245.81
- NY $1,106.22
- OH $1,366.79
- OK $1,288.57
- OR $1,157.38
- PA $1,106.22
- PR $1,225.60
- RI $1,205.74
- SC $1,444.03
- SD $1,106.22
- TN $1,444.03
- TX $1,288.57
- UT $1,106.22
- VA $1,106.22
- VI $1,106.22
- VT $1,205.74
- WA $1,157.38
- WI $1,366.79
- WV $1,106.22
- WY $1,106.22
- AK $402.75
- AL $335.42
- AR $335.41
- AZ $319.33
- CA $205.55
- CO $258.45
- CT $332.23
- DC $304.47
- DE $304.47
- FL $335.42
- GA $335.42
- HI $402.75
- IA $329.86
- ID $254.45
- IL $300.61
- IN $300.61
- KS $329.86
- KY $335.42
- LA $335.41
- MA $332.23
- MD $304.47
- ME $332.23
- MI $300.61
- MN $330.38
- MO $329.86
- MS $335.42
- MT $258.45
- NC $335.42
- ND $331.79
- NE $329.86
- NH $332.23
- NJ $304.47
- NM $322.50
- NV $205.55
- NY $304.47
- OH $300.61
- OK $322.50
- OR $205.55
- PA $304.47
- PR $443.01
- RI $332.23
- SC $335.42
- SD $331.79
- TN $335.42
- TX $322.50
- UT $258.45
- VA $332.23
- VI $443.01
- VT $332.23
- WA $205.55
- WI $300.61
- WV $332.23
- WY $258.45
- AK $1,005.79
- AL $837.66
- AR $837.64
- AZ $797.47
- CA $513.33
- CO $645.45
- CT $829.70
- DC $760.38
- DE $760.38
- FL $837.66
- GA $837.66
- HI $1,005.79
- IA $823.78
- ID $635.44
- IL $750.75
- IN $750.75
- KS $823.78
- KY $837.66
- LA $837.64
- MA $829.70
- MD $760.38
- ME $829.70
- MI $750.75
- MN $825.11
- MO $823.78
- MS $837.66
- MT $645.45
- NC $837.66
- ND $828.63
- NE $823.78
- NH $829.70
- NJ $760.38
- NM $805.42
- NV $513.33
- NY $760.38
- OH $750.75
- OK $805.42
- OR $513.33
- PA $760.38
- PR $1,106.34
- RI $829.70
- SC $837.66
- SD $828.63
- TN $837.66
- TX $805.42
- UT $645.45
- VA $829.70
- VI $1,106.34
- VT $829.70
- WA $513.33
- WI $750.75
- WV $829.70
- WY $645.45
- AK $1,214.61
- AL $1,015.24
- AR $976.38
- AZ $928.40
- CA $599.63
- CO $706.02
- CT $955.67
- DC $850.58
- DE $850.58
- FL $1,015.24
- GA $1,015.24
- HI $1,298.78
- IA $954.01
- ID $718.81
- IL $897.07
- IN $897.07
- KS $954.01
- KY $1,015.24
- LA $976.38
- MA $955.67
- MD $850.58
- ME $955.67
- MI $897.07
- MN $983.11
- MO $954.01
- MS $1,015.24
- MT $706.02
- NC $1,015.24
- ND $917.97
- NE $954.01
- NH $955.67
- NJ $850.58
- NM $939.09
- NV $599.63
- NY $850.58
- OH $897.07
- OK $939.09
- OR $577.52
- PA $850.58
- PR $1,166.12
- RI $955.67
- SC $1,015.24
- SD $917.97
- TN $1,015.24
- TX $939.09
- UT $706.02
- VA $930.79
- VI $1,052.53
- VT $955.67
- WA $577.52
- WI $897.07
- WV $930.79
- WY $706.02
- AK $155.93
- AL $127.91
- AR $141.93
- AZ $156.05
- CA $156.05
- CO $139.89
- CT $150.17
- DC $150.51
- DE $150.51
- FL $127.91
- GA $127.91
- HI $166.74
- IA $130.95
- ID $142.31
- IL $149.94
- IN $149.94
- KS $130.95
- KY $127.91
- LA $141.93
- MA $150.17
- MD $150.51
- ME $150.17
- MI $149.94
- MN $149.94
- MO $130.95
- MS $127.91
- MT $139.89
- NC $127.91
- ND $139.89
- NE $130.95
- NH $150.17
- NJ $145.21
- NM $141.93
- NV $156.05
- NY $145.21
- OH $149.94
- OK $141.93
- OR $142.31
- PA $150.51
- PR $149.17
- RI $150.17
- SC $127.91
- SD $139.89
- TN $127.91
- TX $141.93
- UT $139.89
- VA $150.51
- VI $145.21
- VT $150.17
- WA $142.31
- WI $149.94
- WV $150.51
- WY $139.89
- AK $699.72
- AL $799.66
- AR $599.75
- AZ $716.16
- CA $716.16
- CO $599.75
- CT $783.08
- DC $697.66
- DE $697.66
- FL $799.66
- GA $799.66
- HI $748.22
- IA $599.75
- ID $599.75
- IL $726.70
- IN $726.70
- KS $599.75
- KY $799.66
- LA $599.75
- MA $783.08
- MD $697.66
- ME $783.08
- MI $726.70
- MN $726.70
- MO $599.75
- MS $799.66
- MT $599.75
- NC $799.66
- ND $599.75
- NE $599.75
- NH $783.08
- NJ $799.66
- NM $599.75
- NV $716.16
- NY $799.66
- OH $726.70
- OK $599.75
- OR $599.75
- PA $697.66
- PR $1,389.02
- RI $783.08
- SC $799.66
- SD $599.75
- TN $799.66
- TX $599.75
- UT $599.75
- VA $697.66
- VI $799.66
- VT $783.08
- WA $599.75
- WI $726.70
- WV $697.66
- WY $599.75
- AK $616.16
- AL $594.34
- AR $544.37
- AZ $501.75
- CA $501.75
- CO $478.72
- CT $577.74
- DC $531.66
- DE $531.66
- FL $594.34
- GA $594.34
- HI $639.23
- IA $505.87
- ID $478.72
- IL $543.01
- IN $543.01
- KS $505.87
- KY $594.34
- LA $544.37
- MA $577.74
- MD $531.66
- ME $577.74
- MI $543.01
- MN $537.61
- MO $505.87
- MS $594.34
- MT $478.72
- NC $594.34
- ND $505.87
- NE $505.87
- NH $577.74
- NJ $557.16
- NM $472.65
- NV $501.75
- NY $557.16
- OH $543.01
- OK $472.65
- OR $472.65
- PA $531.66
- PR $944.08
- RI $577.74
- SC $594.34
- SD $505.87
- TN $594.34
- TX $472.65
- UT $478.72
- VA $568.84
- VI $663.70
- VT $577.74
- WA $472.65
- WI $543.01
- WV $568.84
- WY $478.72
- AK $923.94
- AL $951.75
- AR $951.67
- AZ $923.94
- CA $923.94
- CO $957.03
- CT $923.94
- DC $923.94
- DE $923.94
- FL $951.75
- GA $951.75
- HI $923.94
- IA $942.00
- ID $923.94
- IL $946.64
- IN $946.64
- KS $942.00
- KY $951.75
- LA $951.67
- MA $923.94
- MD $923.94
- ME $923.94
- MI $946.64
- MN $946.64
- MO $942.00
- MS $951.75
- MT $957.03
- NC $951.75
- ND $957.03
- NE $942.00
- NH $923.94
- NJ $923.94
- NM $951.67
- NV $923.94
- NY $923.94
- OH $946.64
- OK $951.67
- OR $923.94
- PA $923.94
- PR $1,016.35
- RI $923.94
- SC $951.75
- SD $957.03
- TN $951.75
- TX $951.67
- UT $957.03
- VA $923.94
- VI $1,016.35
- VT $923.94
- WA $923.94
- WI $946.64
- WV $923.94
- WY $957.03
- AK $813.46
- AL $758.55
- AR $758.53
- AZ $656.94
- CA $656.94
- CO $673.22
- CT $735.16
- DC $702.52
- DE $702.52
- FL $758.55
- GA $758.55
- HI $813.46
- IA $705.30
- ID $664.95
- IL $713.59
- IN $713.59
- KS $705.30
- KY $758.55
- LA $758.53
- MA $735.16
- MD $702.52
- ME $735.16
- MI $713.59
- MN $706.46
- MO $705.30
- MS $758.55
- MT $673.22
- NC $758.55
- ND $709.06
- NE $705.30
- NH $735.16
- NJ $702.52
- NM $663.87
- NV $656.94
- NY $702.52
- OH $713.59
- OK $663.87
- OR $656.94
- PA $702.52
- PR $857.41
- RI $735.16
- SC $758.55
- SD $709.06
- TN $758.55
- TX $663.87
- UT $673.22
- VA $751.60
- VI $857.41
- VT $735.16
- WA $656.94
- WI $713.59
- WV $751.60
- WY $673.22
- AK $93.27
- AL $81.03
- AR $105.00
- AZ $90.23
- CA $90.23
- CO $78.75
- CT $90.71
- DC $91.96
- DE $91.96
- FL $81.03
- GA $81.03
- HI $99.72
- IA $83.11
- ID $96.56
- IL $78.75
- IN $78.75
- KS $83.11
- KY $81.03
- LA $105.00
- MA $90.71
- MD $91.96
- ME $90.71
- MI $78.75
- MN $78.75
- MO $83.11
- MS $81.03
- MT $78.75
- NC $81.03
- ND $78.75
- NE $83.11
- NH $90.71
- NJ $103.05
- NM $105.00
- NV $90.23
- NY $103.05
- OH $78.75
- OK $105.00
- OR $96.56
- PA $91.96
- PR $73.55
- RI $90.71
- SC $81.03
- SD $78.75
- TN $81.03
- TX $105.00
- UT $78.75
- VA $91.96
- VI $103.04
- VT $90.71
- WA $96.56
- WI $78.75
- WV $91.96
- WY $78.75
- AK $173.03
- AL $138.28
- AR $113.34
- AZ $145.54
- CA $145.54
- CO $109.16
- CT $109.16
- DC $131.11
- DE $131.11
- FL $138.28
- GA $138.28
- HI $185.01
- IA $145.54
- ID $113.47
- IL $109.16
- IN $109.16
- KS $145.54
- KY $138.28
- LA $113.34
- MA $109.16
- MD $131.11
- ME $109.16
- MI $109.16
- MN $109.16
- MO $145.54
- MS $138.28
- MT $109.16
- NC $138.28
- ND $109.16
- NE $145.54
- NH $109.16
- NJ $129.44
- NM $113.34
- NV $145.54
- NY $129.44
- OH $109.16
- OK $113.34
- OR $113.47
- PA $131.11
- PR $122.56
- RI $109.16
- SC $138.28
- SD $109.16
- TN $138.28
- TX $113.34
- UT $109.16
- VA $131.11
- VI $129.44
- VT $109.16
- WA $113.47
- WI $109.16
- WV $131.11
- WY $109.16
- AK $234.34
- AL $241.40
- AR $241.38
- AZ $234.34
- CA $234.34
- CO $242.69
- CT $234.34
- DC $234.34
- DE $234.34
- FL $241.40
- GA $241.40
- HI $234.34
- IA $238.87
- ID $234.34
- IL $240.08
- IN $240.08
- KS $238.87
- KY $241.40
- LA $241.38
- MA $234.34
- MD $234.34
- ME $234.34
- MI $240.08
- MN $240.08
- MO $238.87
- MS $241.40
- MT $242.69
- NC $241.40
- ND $242.69
- NE $238.87
- NH $234.34
- NJ $234.34
- NM $241.38
- NV $234.34
- NY $234.34
- OH $240.08
- OK $241.38
- OR $234.34
- PA $234.34
- PR $281.22
- RI $234.34
- SC $241.40
- SD $242.69
- TN $241.40
- TX $241.38
- UT $242.69
- VA $234.34
- VI $281.22
- VT $234.34
- WA $234.34
- WI $240.08
- WV $234.34
- WY $242.69
- AK $100.99
- AL $57.83
- AR $57.83
- AZ $77.11
- CA $77.11
- CO $57.83
- CT $77.11
- DC $64.93
- DE $64.93
- FL $57.83
- GA $57.83
- HI $108.05
- IA $58.77
- ID $77.11
- IL $70.40
- IN $70.40
- KS $58.77
- KY $57.83
- LA $57.83
- MA $77.11
- MD $64.93
- ME $77.11
- MI $70.40
- MN $70.40
- MO $58.77
- MS $57.83
- MT $57.83
- NC $57.83
- ND $57.83
- NE $58.77
- NH $77.11
- NJ $77.11
- NM $57.83
- NV $77.11
- NY $77.11
- OH $70.40
- OK $57.83
- OR $77.11
- PA $64.93
- PR $42.86
- RI $77.11
- SC $57.83
- SD $57.83
- TN $57.83
- TX $57.83
- UT $57.83
- VA $64.93
- VI $77.11
- VT $77.11
- WA $77.11
- WI $70.40
- WV $64.93
- WY $57.83
- AK $75.03
- AL $83.97
- AR $83.97
- AZ $83.97
- CA $83.97
- CO $83.97
- CT $111.96
- DC $90.45
- DE $90.45
- FL $83.97
- GA $83.97
- HI $79.43
- IA $85.74
- ID $92.29
- IL $92.75
- IN $92.75
- KS $85.74
- KY $83.97
- LA $83.97
- MA $111.96
- MD $90.45
- ME $111.96
- MI $92.75
- MN $92.75
- MO $85.74
- MS $83.97
- MT $83.97
- NC $83.97
- ND $83.97
- NE $85.74
- NH $111.96
- NJ $83.97
- NM $83.97
- NV $83.97
- NY $83.97
- OH $92.75
- OK $83.97
- OR $92.29
- PA $90.45
- PR $61.95
- RI $111.96
- SC $83.97
- SD $83.97
- TN $83.97
- TX $83.97
- UT $83.97
- VA $90.45
- VI $83.97
- VT $111.96
- WA $92.29
- WI $92.75
- WV $90.45
- WY $83.97
- AK $1,027.94
- AL $795.72
- AR $865.00
- AZ $945.92
- CA $945.92
- CO $709.44
- CT $842.90
- DC $710.08
- DE $710.08
- FL $795.72
- GA $795.72
- HI $1,099.20
- IA $777.58
- ID $797.73
- IL $765.80
- IN $765.80
- KS $777.58
- KY $795.72
- LA $865.00
- MA $842.90
- MD $710.08
- ME $842.90
- MI $765.80
- MN $765.80
- MO $777.58
- MS $795.72
- MT $709.44
- NC $795.72
- ND $709.44
- NE $777.58
- NH $842.90
- NJ $727.69
- NM $865.00
- NV $945.92
- NY $727.69
- OH $765.80
- OK $865.00
- OR $797.73
- PA $710.08
- PR $614.64
- RI $842.90
- SC $795.72
- SD $709.44
- TN $795.72
- TX $865.00
- UT $709.44
- VA $710.08
- VI $727.69
- VT $842.90
- WA $797.73
- WI $765.80
- WV $710.08
- WY $709.44
- AK $321.85
- AL $290.21
- AR $273.15
- AZ $318.68
- CA $318.68
- CO $294.76
- CT $364.20
- DC $303.55
- DE $303.55
- FL $290.21
- GA $290.21
- HI $344.17
- IA $273.15
- ID $364.20
- IL $273.15
- IN $273.15
- KS $273.15
- KY $290.21
- LA $273.15
- MA $364.20
- MD $303.55
- ME $364.20
- MI $273.15
- MN $273.15
- MO $273.15
- MS $290.21
- MT $294.76
- NC $290.21
- ND $294.76
- NE $273.15
- NH $364.20
- NJ $283.38
- NM $273.15
- NV $318.68
- NY $283.38
- OH $273.15
- OK $273.15
- OR $364.20
- PA $303.55
- PR $315.42
- RI $364.20
- SC $290.21
- SD $294.76
- TN $290.21
- TX $273.15
- UT $294.76
- VA $303.55
- VI $283.38
- VT $364.20
- WA $364.20
- WI $273.15
- WV $303.55
- WY $294.76
- AK $163.25
- AL $168.17
- AR $168.16
- AZ $163.25
- CA $163.25
- CO $169.10
- CT $163.25
- DC $163.25
- DE $163.25
- FL $168.17
- GA $168.17
- HI $163.25
- IA $166.47
- ID $163.25
- IL $167.28
- IN $167.28
- KS $166.47
- KY $168.17
- LA $168.16
- MA $163.25
- MD $163.25
- ME $163.25
- MI $167.28
- MN $167.28
- MO $166.47
- MS $168.17
- MT $169.10
- NC $168.17
- ND $169.10
- NE $166.47
- NH $163.25
- NJ $163.25
- NM $168.16
- NV $163.25
- NY $163.25
- OH $167.28
- OK $168.16
- OR $163.25
- PA $163.25
- PR $179.62
- RI $163.25
- SC $168.17
- SD $169.10
- TN $168.17
- TX $168.16
- UT $169.10
- VA $163.25
- VI $179.62
- VT $163.25
- WA $163.25
- WI $167.28
- WV $163.25
- WY $169.10
- AK $169.89
- AL $178.05
- AR $178.04
- AZ $169.89
- CA $169.89
- CO $175.77
- CT $180.52
- DC $172.78
- DE $172.78
- FL $178.05
- GA $178.05
- HI $169.89
- IA $169.89
- ID $169.89
- IL $177.05
- IN $177.05
- KS $169.89
- KY $178.05
- LA $178.04
- MA $180.52
- MD $172.78
- ME $180.52
- MI $177.05
- MN $177.05
- MO $169.89
- MS $178.05
- MT $175.77
- NC $178.05
- ND $175.77
- NE $169.89
- NH $180.52
- NJ $172.78
- NM $178.04
- NV $169.89
- NY $172.78
- OH $177.05
- OK $178.04
- OR $169.89
- PA $172.78
- PR $207.37
- RI $180.52
- SC $178.05
- SD $175.77
- TN $178.05
- TX $178.04
- UT $175.77
- VA $172.78
- VI $172.78
- VT $180.52
- WA $169.89
- WI $177.05
- WV $172.78
- WY $175.77
Current Medicare Fee Schedule
- L0626 -
Current Medicare Fee Schedule
- L0627 -
Current Medicare Fee Schedule
- L0631 -
Current Medicare Fee Schedule
- L0637 -
Current Medicare Fee Schedule
- L0642 -
Current Medicare Fee Schedule
- L0648 -
Current Medicare Fee Schedule
- L0650 -
Current Medicare Fee Schedule
- L1820 -
Current Medicare Fee Schedule
- L1832 -
Current Medicare Fee Schedule
- L1833 -
Current Medicare Fee Schedule
- L1843 -
Current Medicare Fee Schedule
- L1851 -
Current Medicare Fee Schedule
- L1902 -
Current Medicare Fee Schedule
- L3670 -
Current Medicare Fee Schedule
- L3807 -
Current Medicare Fee Schedule
- L3908 -
Current Medicare Fee Schedule
- L3923 -
Current Medicare Fee Schedule
- L3960 -
Current Medicare Fee Schedule
- L4361 -
Current Medicare Fee Schedule
- L4387 -
Current Medicare Fee Schedule
- L4397 -
LCD Information
Application Instructions
- TriLok Ankle Brace
- STO Ankle Brace
- AFTR DC
- AFTR
- Weil Osteotomy Strap
- Hallux Control Strap
- CMC Wrap
- Standard Ankle Skin
- Compression Shorts
- Calf Skin
- UnderSkin
- Thigh Skin
- Q Baby
- Premium J
- Patella Stabilizer
- Knee Skin
- Hinged Knee Skin
- Hinged Knee Skin FC
- Gladiator
- Gladiator FC
- CrossFire OA
- CrossFire Aluminum FC
- Visco Knee
- Q Lok
- Q Lok FC
- Q Brace
- Q Brace FC