decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 5102 / 5102
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Article Overview
This Medicare Carriers Manual article covers fee schedule policy for durable medical equipment, prosthetics, and orthotics under Medicare Part B. It is relevant to coders, billing staff, and reimbursement professionals who need a general understanding of how these payment categories are organized and how geographic locality affects fee schedule development. The article also references related Medicare reimbursement material and discusses the framework used for different classes of equipment across specified time periods.
Why This Topic Matters
It helps readers identify the policy backdrop for Medicare payment of durable medical equipment and orthotic/prosthetic devices and understand that locality and item classification affect fee schedule structure.
Article Sections
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Ed. Note: For further information see
A short editorial note pointing readers to related reimbursement guidance in another manual chapter.
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5102. Fee Schedules for Durable Medical Equipment and Orthotic/Prosthetic Devices
An overview of Medicare Part B fee schedule policy for equipment and device categories, along with the general framework and effective-date context described in the manual.
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A. General
Background on the statutory basis for fee schedules and the broad classification of equipment into payment categories under the manual's framework.
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B. Geographic Basis
A discussion of how fee schedules are developed using locality-based geographic rules within a carrier's service area.
What You Will Learn
- The Medicare policy context for fee schedules covering durable medical equipment and orthotic/prosthetic devices.
- How the article organizes equipment into broad payment categories.
- How geographic locality factors into fee schedule development.
- Which effective-date milestones are referenced in the manual discussion.
Who Should Read This
- Medical coders
- Billing staff
- Reimbursement specialists
- Medicare claims personnel
- Durable medical equipment suppliers
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