Notification of Commercial Reimbursement Policy Revisions Effective November 12, 2023 (Posted September 12, 2023)
| Reimbursement Policy | Revision |
|---|---|
| Bundling Guidelines (PDF) | Wheelchair Bundling renamed to “DME Bundling.” Medical Director Approved. Notification on 9/12/2023 for effective date 11/12/2023. |
| Pricing and Adjudication Principles (PDF) | Added bullet 16 for overlapping or duplicative services. Medical Director approved. Notification on 9/12/2023 for effective date 11/12/2023. |
| Supply and Equipment (PDF) | Policy language added to Supplies and Equipment Billing Requirements. Added TENS device modifier requirements, therapeutic mold inserts for diabetics, intermittent catheter, reimbursement of portable oxygen and accessories, routinely purchased DME. Added diabetic shoes and inserts and category “IN” DME to Non-Reimbursable Supplies and Equipment. Medical Director approved. Notification on 9/12/2023 for effective date 11/12/2023. |
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