Medicare Claims Processing Manual (Pub. 100-04), Ch. 19 § 90.1.2
Payment
90.1.2 - Payment
(Rev. 1040, Issued: 08-25-06, Effective: 09-11-06, Implementation: 09-11-06)
Surgical dressings, splints, casts, DME and other devices used for reductions of fractures
and dislocations are paid based on the DMEPOS fee schedule. Claims will be priced
using the appropriate DMEPOS fee schedule based on the beneficiary’s address.
Payment for DME MAC-covered drug claims shall be based on the ASP fee schedule or
other sources (See Pub. 100-04, Medicare Claims Processing Manual, Chapter 17, §20).
Payment for prosthetics and orthotics is based on the DMEPOS fee schedule by the A/B
MAC (A) and DME MAC.