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The 2023 reimbursement rates have been released! We have provided the 2023 vs. 2022 A5500, A5512 and A5514 rates, as well as the exact reimbursement by state. The Medicare fee schedules published by the Centers for Medicare and Medicaid Services (CMS) are linked here.
|
HCPCS |
2023 |
Difference |
2022 |
Difference |
2021 |
|
A5500 |
$169.14 |
$13.54 |
$155.60 |
$7.56 |
$148.04 |
|
A5512 |
$68.98 |
$5.52 |
$63.46 |
$3.08 |
$60.38 |
|
A5514 |
$102.94 |
$8.24 |
$94.70 |
$4.60 |
$90.10 |
|
Shoes w/ 3 pairs of HM |
$376.08 |
$30.10 |
$345.98 |
$16.80 |
$329.18 |
|
Shoes w/ 3 pairs of CI |
$477.96 |
$38.26 |
$439.70 |
$21.36 |
$418.34 |
*Please note reimbursement on L codes will vary based on patient’s available coverage and associated health plan.
|
HCPCS |
L3010 |
L3020 |
L5000 |
|
Ceiling |
$ 476.06 |
$ 542.00 |
$ 769.61 |
|
Floor |
$ 357.04 |
$ 406.50 |
$ 577.21 |
|
AL |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
AR |
$ 401.78 |
$ 457.46 |
$ 769.61 |
|
AZ |
$ 390.14 |
$ 444.12 |
$ 686.55 |
|
CA |
$ 390.14 |
$ 444.12 |
$ 686.55 |
|
CO |
$ 404.02 |
$ 460.02 |
$ 577.21 |
|
CT |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
DC |
$ 390.14 |
$ 444.12 |
$ 636.72 |
|
DE |
$ 390.14 |
$ 444.12 |
$ 636.72 |
|
FL |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
GA |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
IA |
$ 397.74 |
$ 452.82 |
$ 602.98 |
|
ID |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
IL |
$ 399.60 |
$ 455.06 |
$ 658.53 |
|
IN |
$ 399.60 |
$ 455.06 |
$ 658.53 |
|
KS |
$ 397.74 |
$ 452.82 |
$ 602.98 |
|
KY |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
LA |
$ 401.78 |
$ 457.46 |
$ 769.61 |
|
MA |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
MD |
$ 390.14 |
$ 444.12 |
$ 636.72 |
|
ME |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
MI |
$ 399.60 |
$ 455.06 |
$ 658.53 |
|
MN |
$ 399.60 |
$ 455.06 |
$ 658.53 |
|
MO |
$ 397.74 |
$ 452.82 |
$ 602.98 |
|
MS |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
MT |
$ 404.02 |
$ 460.02 |
$ 577.21 |
|
NC |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
ND |
$ 404.02 |
$ 460.02 |
$ 577.21 |
|
NE |
$ 397.74 |
$ 452.82 |
$ 602.98 |
|
NH |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
NJ |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
NM |
$ 401.78 |
$ 457.46 |
$ 769.61 |
|
NV |
$ 390.14 |
$ 444.12 |
$ 686.55 |
|
NY |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
OH |
$ 399.60 |
$ 455.06 |
$ 658.53 |
|
OK |
$ 401.78 |
$ 457.46 |
$ 769.61 |
|
OR |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
PA |
$ 390.14 |
$ 444.12 |
$ 636.72 |
|
RI |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
SC |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
SD |
$ 404.02 |
$ 460.02 |
$ 577.21 |
|
TN |
$ 401.80 |
$ 457.52 |
$ 604.59 |
|
TX |
$ 401.78 |
$ 457.46 |
$ 769.61 |
|
UT |
$ 404.02 |
$ 460.02 |
$ 577.21 |
|
VA |
$ 390.14 |
$ 444.12 |
$ 636.72 |
|
VT |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
WA |
$ 390.14 |
$ 444.12 |
$ 577.21 |
|
WI |
$ 399.60 |
$ 455.06 |
$ 658.53 |
|
WV |
$ 390.14 |
$ 444.12 |
$ 636.72 |
|
WY |
$ 404.02 |
$ 460.02 |
$ 577.21 |
|
AK |
$ 390.14 |
$ 444.12 |
$ 671.58 |
|
HI |
$ 390.14 |
$ 444.12 |
$ 718.18 |
|
PR |
$ 429.08 |
$ 488.48 |
$ 932.55 |
|
VI |
$ 429.08 |
$ 488.48 |
$ 577.21 |
If you have absolutely any questions on 2023 Medicare reimbursement rates for diabetic shoes and inserts, please do not hesitate to reach out!
Resource –
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