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Fee Schedules

CMS sets the DMEPOS Fee Schedule. The fee schedules list the highest amount Medicare will pay per unit for the associated HCPCS code. Keep in mind that just because an item has a price listed doesn’t mean Medicare will cover it.

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

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