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Fee Schedules

What are Fee Schedules?

Fee schedules are lists of the maximum allowable amount per unit for the associated HCPCS codes. Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.   The DMEPOS Fee Schedule is based on the DMEPOS and PEN Fee Schedule Files provided by the CMS.  The Drug Fees, Pharmacy Dispensing Fees and Pharmacy Supply Fees are based on the CMS Quarterly Average Sales Price (ASP) Files, Change Request instructions and instructions in the Internet-Only Manual (IOM),  Publication 100-04, Medicare Claims Processing Manual, Chapter 17.

DMEPOS Fee Schedule

This section contains current and previous year fee schedules. DMEPOS fee schedule information is available to you in a variety of formats including .CSV files, PDF, and through a searchable online database.

Drug Fees, Pharmacy Dispensing Fees and Pharmacy Supply Fees (by year)

Fee schedules for Drug, Pharmacy Dispensing and Pharmacy Supplies are currently only available in PDF form. This section contains current and previous year fees.

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