On January 9, 2018, CMS published its final changes to the DMEPOS Quality Standards, specifically the standards that address the definition of the term “molded to patient model” as it relates to the provision of custom fabricated diabetic inserts. CMS made only one small change to the definitions it included in its November 2, 2017 […]
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CMS Releases the 2018 Medicare DMEPOS Fee Schedule
The Centers for Medicare and Medicaid Services (CMS) has released the 2018 Medicare DMEPOS fee schedule which will be effective for Medicare claims with a date of service on or after January 1, 2018. The 2018 Medicare fee schedule for orthotic and prosthetic services will be increased by 1.1% over 2017 rates. The 1.1% increase […]
AOPA Submits Comments and Publishes Ad on Proposed Rule That Would Limit a Veteran’s Right to Choose Their Orthotic and Prosthetic Provider
The October 16, 2017 Federal Register included a proposed rule published by the Department of Veterans Affairs (VA) that intends to “reorganize and update the current regulations related to prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible […]
AOPA Submits Comments on CMS Proposed Change to the DMEPOS Quality Standards
On December 11, 2017, AOPA submitted formal comments on CMS’ proposed change to the DMEPOS Quality Standards that would expand the definition of the term “molded to patient model” to include custom fabricated diabetic inserts that are fabricated using a virtual or digital model of the patient’s foot and a direct milling process. Earlier this […]
Action item: Tell CMS not to charge providers a toll for using advanced technology to fabricate diabetic inserts
Submit comments on the CMS proposed changes to the DMEPOS quality standards that would include a 14% reduction in reimbursement for custom fabricated, direct milled diabetic inserts. In July, the DME MACs released a clarification stating that diabetic inserts billed using A5513 must be molded over an actual model of the patient’s foot. At that […]
AOPA Participates in CMS Special Open Door Forum on Proposed Revisions to DMEPOS Quality Standards on Diabetic Inserts
On November 28, 2017, AOPA participated in a Special Open Door Forum hosted by the Centers for Medicare and Medicaid Services (CMS). The purpose of the Special Open Door Forum was to receive input from experts and stakeholders regarding proposed changes to the DMEPOS quality standards that would expand the definition of the term “molded […]
AOPA Submits Comments on the CMS Proposed Rule That Would Provide States with Additional Flexibility in Defining Essential Health Benefits
On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register entitled “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019.” Among the provisions in the proposed rule is a section that would provide individual states with increased flexibility in […]
Access AOPA Funded Epidemiology Research: Incidence Rate and Prevalence of Partial Foot Amputation
We are pleased to share that the AOPA funded research by Dr. Michael Dillon describing the incident rate and prevalence of partial foot amputation and how this compares to transtibial amputation has now been published in the journal Systematic Reviews. The article is freely available at the link below. https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-017-0626-0.
HCPCS Code Changes for 2018
The Centers for Medicare and Medicaid Services (CMS) has released the new HCPCS codes for 2018, and there were only a few minor changes. Below is a complete breakdown of the code changes which will be effective for claims with a date of service on or after January 1, 2018. New Codes Changes in Code […]
CMS Responds to AOPA Concerns Regarding Custom Fabricated Diabetic Inserts
AOPA is pleased to announce that the Centers for Medicare and Medicaid Services (CMS) has proposed a change to the DMEPOS Quality Standards that addresses AOPA’s concern regarding the recent DME MAC/PDAC interpretation of the term “molded to patient model” when used to describe custom fabricated diabetic shoe inserts. The proposed change to the quality […]