Skip to Main Content

Print | Bookmark | Email | Font Size: + |

Fee Schedules

Fee schedules are lists of the maximum allowable amount per unit for the associated HCPCS codes. Pricing for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) is based on the fee schedules and payment methodologies provided by CMS. Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.

Find more information on the following resources:

The Supplier Manual includes helpful information about pricing and fee schedules in Chapter 5 – DMEPOS Fee Schedule CategoriesPDF and Chapter 10 – PricingPDF.

The Advanced Modifier Engine (AME) helps suppliers bill proper HCPCS codes and modifier combinations for common DMEPOS billing scenarios. Enter a specific HCPCS code and the billing scenario, and the tool will recommend modifiers for claim submission

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved