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Medicare DME Reimbursement to Increase in 2017

Good news!

On January 1, 2017, the amount Medicare pays for diabetic shoes, Moore Balance Brace and Arizona custom AFOs will increase.

While the amount reimbursed may vary slightly by state, the National Fee Schedule is as follows:

Depth Shoes (A5500), pair                                                            $141.56

Prefabricated, Heat Molded Inserts (A5512), pair                         $57.74

Custom Molded Inserts (A5513), pair                                            $86.18

Depth Shoes w/ 3 pr. Prefab, Heat Molded Inserts                       $314.78

Depth Shoes w/ 3 pr. Custom Molded Inserts                               $400.10

Custom Molded Shoes w/ offset heels and rocker bottoms          $564.26

Arizona AFO, Standard (L1940, L2330, L2820), each  – Ceiling $1171.79      Floor  $874.33

Moore Balance Brace (L1940, L2330, L2820), pair       – Ceiling $2343.58    Floor  $1748.66

For a complete listing of updated DME allowables, including prefabricated and custom ankle foot orthoses, go to:

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule-Items/DME17-A.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending

2016 Patient Brochure Helps Ensure That Patients With Diabetes Get Evaluated For Annual Shoe Fitting

More than 75% of patients with diabetes that are fit with shoes covered by Medicare are only fit one year and not the next. Despite the American Diabetes Association recommending that patients be evaluated annually to determine their level of ulcerative risk, and the annual coverage that offers podiatrists very reasonable reimbursement, patients are still not receiving the attention they deserve. SafeStep has created a brochure for podiatrists to give to patients with Medicare and diabetes when scheduling an annual Comprehensive Diabetic Foot Exam.  The brochure explains to patients the importance of the annual exam as well as qualifications for shoes under the Therapeutic Shoe Program.

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Increased Medicare DME Reimbursement for 2015

Good news!! On January 1, 2015, the Medicare fee schedule for diabetic shoes, Moore Balance Brace and Arizona custom AFOs increased. While the amount reimbursed by each DME MAC may vary slightly, the National Fee Schedule allowables are as follows:

Depth Shoes (A5500) $141.14
Prefabricated, Heat Molded Inserts (A5512) $57.58
Custom Molded Inserts (A5513) $85.92

Depth Shoes w/ 3 pr. Prefab, Heat Molded Inserts $313.88
Depth Shoes w/ 3 pr. Custom Molded Inserts $398.90
Custom Molded Shoes w/ Custom Molded Inserts $586.42

Arizona AFO, Standard (L1940, L2330, L2820) $1162.23
Moore Balance Brace (L1940, L2330, L2820) $1162.23

For a complete listing of updated DME prices, including prefabricated and custom ankle foot orthoses, go to:
http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html.