Well, it looks as though CMS has released the fee schedule for 2015. Below listed are a few notes.
1. There is a 1.5% increase from the 2014 Fee Schedule.
2. The bifurcated OTS orthotic codes schedule mirrors the Pre Fabricated Custom Fit “with Expertise” schedule.
L0631 $987.92 (AL-Custom Pre Fab) L0648 $987.92 (AL-OTS)
L1832 $725.49 (AL-Custom Pre Fab) L1833 $725.49 (AL-OTS)
L3807 $219.01 (AL-Custom Pre Fab) L3809 $219.01 (AL-OTS)
What does this mean? Barring any mid-year or end of year 2015 retro-active changes, supplying OTS product will generate the same levels of revenue as the PreFab “fit with expertise”. This does seem understandable, since CMS tabled the final ruling for a description of “one with expertise”. What i think this also means is CMS will be looking at including these OTS codes for Round 2 of Competitive Bidding in July of 2016.
Here is a link to the complete 2015 Fee Schedule