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CGS Associates, LLC

December 28, 2016

2017 Jurisdiction C Labor Fees

The labor payment amounts for the HCPCS codes below are effective for claims submitted for Jurisdiction C states with dates of service from January 1, 2017 through December 31, 2017.

K0739 - Repair or nonroutine service for DME other than oxygen requiring the skill of a technician, labor component, per 15 minutes

L4205 - Repair of orthotic device, labor component, per 15 minutes

L7520 - Repair of prosthetic device, labor component, per 15 minutes

State K0739 L4205 L7520
AL $15.02 $22.38 $30.38
AR $15.02 $22.38 $30.38
CO $15.02 $22.38 $30.38
FL $15.02 $22.38 $30.38
GA $15.02 $22.38 $30.38
LA $15.02 $22.38 $30.38
MS $15.02 $22.38 $30.38
NC $15.02 $22.38 $30.38
NM $15.02 $22.38 $30.38
OK $15.02 $22.38 $30.38
PR $15.02 $22.38 $30.38
SC $15.02 $22.38 $30.38
TN $15.02 $22.38 $30.38
TX $15.02 $22.38 $30.38
VA $15.02 $22.35 $30.38
VI $15.02 $22.38 $30.38
WV $15.02 $22.35 $30.38
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