Blog: Daisy News

News, data, & insights about workers' comp billing

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92% of DMEPOS Reimbursements to Change in 2017

December 22, 2016 by Catherine Montgomery

2017 is almost upon us, and the Division of Workers’ Compensation (DWC) is ringing in the new year with an adjustment to the Official Medical Fee Schedule (OMFS). The new order adjusts the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) section of the OMFS for dates of service on or after January 1st, 2017, to conform to Medicare’s first quarter changes. A staggering 92% of DMEs are affected by this order – buckle up and join us as we take a closer look.

DaisyBill’s OMFS Calculator collects data every time one of our clients submits a bill. From the hundreds of million  resulting data points, we can identify the most commonly-used HCPCS across the California workers’ comp community. Here, then, are the ten most popular DMEPOS HCPCS set to change in the new year. Most of the changes are fairly minor, with a few dramatic decreases sprinkled in to keep coders on their toes.

HCPCS

Reimbursement effective 7/1/2016

Reimbursement effective 1/1/2017

Percent Change

L3908

$83.61

$84.20

0.71%

A4595

11.28

10.75

-4.70%

L0637

1350.87

1360.33

0.70%

E0730*

77.49

70.80

-8.63%

L3807

254.10

255.87

0.70%

E0217*

658.63

663.24

0.70%

L1832

776.55

781.99

0.70%

L3020

221.53

223.08

0.70%

L0627

458.97

462.19

0.70%

E0100*

26.52

26.70

0.68%

*Prices for E0730, E0217, and E0100 use modifier NU

The DaisyBill OMFS calculator already incorporates these fee schedule changes effective 1/1/2017. To see them before they officially take effect, simply enter a service date of January 1st or later. Should you ever need the old reimbursements, we always retain the previous reimbursements into our historical database.

For more information about this update, view the DIR Newsline 2016-117 or visit the DWC website.

In the meantime, stay tuned – we’ll be back with more updates as the new year approaches.


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