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Medicare DME Reimbursement for 2016

On October 1, 2016, the Medicare fee schedule for diabetic shoes, Moore Balance Brace and Arizona custom AFOs was revised .

While the amount reimbursed by each DME MAC may vary slightly, the National Fee Schedule allowables are as follows:,

Depth Shoes (A5500) $140.58
Prefabricated, Heat Molded Inserts (A5512) $57.34
Custom Molded Inserts (A5513) $85.58
Depth Shoes w/ 3 pr. Prefab, Heat Molded Inserts $312.60
Depth Shoes w/ 3 pr. Custom Molded Inserts $397.32
Custom Molded Shoes w/ offset heels and rocker bottoms $628.96
Arizona AFO, Standard (L1940, L2330, L2820) $1,157.69
Moore Balance Brace (L1940, L2330, L2820) $1,157.69
For a complete listing of updated DME prices, including prefabricated and custom ankle foot orthoses, go to:

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule-Items/DME16-D.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending