CMS Releases the 2019 Medicare DMEPOS Fee Schedule
The Centers for Medicare and Medicaid Services (CMS) has released the 2019 Medicare DMEPOS fee schedule which will be effective for Medicare claims with a date of service on or after January 1, 2019. The 2018 Medicare fee schedule for orthotic and prosthetic services will be increased by 2.3% over 2018 rates. The 2.3% increase is a net reflection of the 2.9% increase in the Consumer Pricing Index for Urban Areas (CPI-U) from June 2017 through June 2018, combined with the annual Multi-Factor Productivity Adjustment (MFP) of -0.6%.
The 2.3% increase in the O&P Medicare fee schedule for 2019 represents a 1.2% larger amount than the 2018 increase of 1.1%. Unfortunately, the 2% sequestration-based reduction to all Medicare payments remains in effect meaning that Medicare fee for service payments will continue to be reduced by 2% due to sequestration. While sequestration continues to impact Medicare reimbursement, it is not cumulative. You will still receive 2.3% more for a service you provide in 2019 then you did in 2018 since the 2% sequestration reduction would be applied to both claims.
|A5500||TS||87.85||65.89||73.21||Diab shoe for density insert|
|A5501||TS||263.51||197.63||219.59||Diabetic custom molded shoe|
|A5503||TS||43.49||32.62||36.24||Diabetic shoe w/roller/rockr|
|A5504||TS||43.49||32.62||36.24||Diabetic shoe with wedge|
|A5505||TS||43.49||32.62||36.24||Diab shoe w/metatarsal bar|
|A5506||TS||43.49||32.62||36.24||Diabetic shoe w/off set heel|
|A5507||TS||43.49||32.62||36.24||Modification diabetic shoe|
|A5512||TS||35.83||26.87||29.86||Multi den insert direct form|
|A5513||TS||53.47||40.1||44.56||Multi den insert custom mold|
|A5514||TS||53.47||40.1||44.56||Mult den insert dir carv/cam|