| Jurisdiction A DME MAC | ||||||||||||||
| 2010 DMEPOS Fee Schedule Updates | ||||||||||||||
| Inclusion of a fee schedule amount for an item does not necessarily indicate coverage | ||||||||||||||
| Frequently Serviced Items | ||||||||||||||
| HCPCS | Mod1 | Mod2 | CT | DC | DE | MA | MD | ME | NH | NJ | NY | PA | RI | VT |
| E0450 | RR | $1,002.25 | $902.44 | $1,002.25 | $1,002.25 | $851.91 | $932.06 | $1,002.25 | $1,002.25 | $1,002.25 | $1,002.25 | $1,002.25 | $879.45 | |
| E0460 | RR | $770.25 | $654.71 | $654.71 | $654.71 | $770.25 | $654.71 | $654.71 | $654.71 | $654.71 | $654.71 | $654.71 | $654.71 | |
| E0461 | RR | $1,002.25 | $902.44 | $1,002.25 | $1,002.25 | $851.91 | $932.06 | $1,002.25 | $1,002.25 | $1,002.25 | $1,002.25 | $1,002.25 | $879.45 | |
| E0463 | RR | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | |
| E0464 | RR | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | $1,476.70 | |
| E0500 | RR | $112.38 | $105.23 | $108.50 | $115.26 | $110.73 | $115.26 | $115.26 | $115.26 | $115.26 | $109.27 | $115.26 | $115.26 | |
| E0575 | RR | $107.92 | $91.73 | $104.09 | $107.92 | $95.64 | $107.92 | $107.92 | $107.92 | $107.92 | $99.38 | $107.92 | $107.92 | |
| E0935 | RR | $23.87 | $23.87 | $23.87 | $23.87 | $23.87 | $23.87 | $23.87 | $23.87 | $20.29 | $23.87 | $20.29 | $23.87 | |
| K0455 | RR | $278.11 | $278.11 | $236.39 | $236.39 | $270.78 | $236.39 | $236.39 | $236.39 | $236.39 | $236.39 | $242.83 | $236.39 | |