Guide to Finding Medicare Payment Rates for Summer 2021
Learn how to search for Medicare payment rates for medical devices in Summer 2021. Follow steps to access the CMS website, find your device code, search for the fee schedule, and determine payment amounts.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
HOW TO SEARCH FOR MEDICARE PAYMENT RATES Summer 2021
Navigate to the CMS website: https://www.cms.gov/medicare/physician-fee- schedule/search/overview In the search bar, enter the name of your device type and hit Search. In this example, we will use crutches GETTING STARTED Next, click on the document titled Local Coverage Determination for *insert device name* . In this example, we will select Local Coverage Determination for Canes and Crutches (L33733)
FINDING YOUR DEVICE CODE Within the Local Coverage Determination (LCD) document, scroll down to the Coding Information section. Read each description and select the code that best fits the description of your device. In this example, we will use E0114
Return back to the CMS search bar. In the Search bar, search the CPT/HCPCS code for your device which you found on the LCD document. In this example, we will search HCPCS E0114 USING THE CODE TO FIND THE FEE SCHEDULE Next, click on the document titled Medicare DMEPOS Fee Schedule.
ACCESSING THE DMEPOS DOCUMENT Within the DMEPOS Fee Schedule Page, click on the most recently updated fee schedule link. This will take you to a new page where you can download a ZIP file of the payment schedule. Click on the file name to download.
Open the Zip file on your computer Open the most up to date DMEPOS file. In this scenario, we are opening DMEPOS_Jan.xlsx In column A of the spreadsheet, find your device s HCPCS. Once you find the code, the columns to the right will correspond with the payment amounts from Medicare for the associated US States. ACCESSING THE PAYMENT The Ceiling amount will indicate the maximum payment amount given by Medicare, and the Floor will indicate the minimum paid out by Medicare. Here we can see that in the state of Georgia today, Medicare pays $46.70 for new crutches.
