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Attention: Durable Medical Equipment Providers

In response to public comments for State Plan Amendment (SPA) 20-0001 Durable Medical Equipment (DME) and Medical Supply Reimbursement, the codes below will be removed from the proposed DME fee schedule. Effective March 1, 2020, DOM will continue to reimburse these codes through manual pricing. Please refer to the initial public notice and proposed fee schedule for this SPA on DOM’s website DME and Medical Supply Reimbursement SPA and Public Notice.

Code      Description
A7520     Tracheostomy/Laryngectomy Tube, Non-Cuffed
A7521     Tracheostomy/Laryngectomy Tube, Cuffed
B4088     Gastrostomy/Jejunostomy Tube, Low profile