The 2021 reimbursement rates have been released! We have provided the 2021 vs. 2020 A5500, A5512 and A5514 rates, as well as the exact reimbursement by state. The Medicare fee schedules are linked here.
|
HCPCS |
2021 |
2020 |
Difference |
|
A5500 |
$ 148.04 |
$ 147.74 |
$ 0.30 |
|
A5512 |
$ 60.38 |
$ 60.26 |
$ 0.12 |
|
A5514 |
$ 90.10 |
$ 89.92 |
$ 0.18 |
|
Shoes w/ 3 pairs of HM |
$ 329.18 |
$ 328.52 |
$ 0.66 |
|
Shoes w/ 3 pairs of CI |
$ 418.34 |
$ 417.50 |
$ 0.84 |
*Please note reimbursement on L codes will vary based on patient’s available coverage and associated health plan.
|
L3010 |
L3020 |
L5000 |
|
|
Ceiling |
$ 208.35 |
$ 237.21 |
$ 673.66 |
|
Floor |
$ 156.26 |
$ 177.91 |
$ 505.24 |
|
AL |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
AR |
$ 175.84 |
$ 200.21 |
$ 673.66 |
|
AZ |
$ 170.75 |
$ 194.38 |
$ 600.95 |
|
CA |
$ 170.75 |
$ 194.38 |
$ 600.95 |
|
CO |
$ 176.82 |
$ 201.33 |
$ 505.24 |
|
CT |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
DC |
$ 170.75 |
$ 194.38 |
$ 557.34 |
|
DE |
$ 170.75 |
$ 194.38 |
$ 557.34 |
|
FL |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
GA |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
IA |
$ 174.07 |
$ 198.18 |
$ 527.80 |
|
ID |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
IL |
$ 174.89 |
$ 199.16 |
$ 576.42 |
|
IN |
$ 174.89 |
$ 199.16 |
$ 576.42 |
|
KS |
$ 174.07 |
$ 198.18 |
$ 527.80 |
|
KY |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
LA |
$ 175.84 |
$ 200.21 |
$ 673.66 |
|
MA |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
MD |
$ 170.75 |
$ 194.38 |
$ 557.34 |
|
ME |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
MI |
$ 174.89 |
$ 199.16 |
$ 576.42 |
|
MN |
$ 174.89 |
$ 199.16 |
$ 576.42 |
|
MO |
$ 174.07 |
$ 198.18 |
$ 527.80 |
|
MS |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
MT |
$ 176.82 |
$ 201.33 |
$ 505.24 |
|
NC |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
ND |
$ 176.82 |
$ 201.33 |
$ 505.24 |
|
NE |
$ 174.07 |
$ 198.18 |
$ 527.80 |
|
NH |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
NJ |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
NM |
$ 175.84 |
$ 200.21 |
$ 673.66 |
|
NV |
$ 170.75 |
$ 194.38 |
$ 600.95 |
|
NY |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
OH |
$ 174.89 |
$ 199.16 |
$ 576.42 |
|
OK |
$ 175.84 |
$ 200.21 |
$ 673.66 |
|
OR |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
PA |
$ 170.75 |
$ 194.38 |
$ 557.34 |
|
RI |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
SC |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
SD |
$ 176.82 |
$ 201.33 |
$ 505.24 |
|
TN |
$ 175.85 |
$ 200.24 |
$ 529.21 |
|
TX |
$ 175.84 |
$ 200.21 |
$ 673.66 |
|
UT |
$ 176.82 |
$ 201.33 |
$ 505.24 |
|
VA |
$ 170.75 |
$ 194.38 |
$ 557.34 |
|
VT |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
WA |
$ 170.75 |
$ 194.38 |
$ 505.24 |
|
WI |
$ 174.89 |
$ 199.16 |
$ 576.42 |
|
WV |
$ 170.75 |
$ 194.38 |
$ 557.34 |
|
WY |
$ 176.82 |
$ 201.33 |
$ 505.24 |
|
AK |
$ 170.75 |
$ 194.38 |
$ 587.85 |
|
HI |
$ 170.75 |
$ 194.38 |
$ 628.64 |
|
PR |
$ 187.79 |
$ 213.79 |
$ 816.28 |
|
VI |
$ 187.79 |
$ 213.79 |
$ 505.24 |
If you have absolutely any questions, please do not hesitate to reach out!
Resource –
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