Payment for Durable Medical Equipment and Prosthetic and Orthotic Devices

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medicare Program
  6. Payment for Part B Medical and Other Health Services
  7. Payment for Durable Medical Equipment and Prosthetic and Orthotic Devices

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Section
414.200

Purpose.

Section
414.202

Definitions.

Section
414.210

General payment rules.

Section
414.220

Inexpensive or routinely purchased items.

Section
414.222

Items requiring frequent and substantial servicing.

Section
414.224

Customized items.

Section
414.226

Oxygen and oxygen equipment.

Section
414.228

Prosthetic and orthotic devices.

Section
414.229

Other durable medical equipment - capped rental items.

Section
414.230

Determining a period of continuous use.

Section
414.232

Special payment rules for transcutaneous electrical nerve stimulators (TENS).

Section
414.234

Prior authorization for items frequently subject to unnecessary utilization.

Section
414.236

Continuity of pricing when HCPCS codes are divided or combined.

Section
414.238

Establishing fee schedule amounts for new HCPCS codes for items and services without a fee schedule pricing history.

Section
414.240

Procedures for making benefit category determinations and payment determinations for new durable medical equipment, prosthetic devices, orthotics and prosthetics, surgical dressings, and therapeutic shoes and inserts.