| Jurisdiction A DME MAC | ||||||||||||||
| 3rd Quarter 2006 DMEPOS/PEN Fee Schedule Updates | ||||||||||||||
| Revised October 1, 2006 | ||||||||||||||
| Inclusion of a fee schedule amount for an item does not necessarily indicate coverage | ||||||||||||||
| MOD1 | MOD2 | CT | DC | DE | MA | MD | ME | NH | NJ | NY | PA | RI | VT | |
| E1238 | NU | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | $1,638.73 | |
| E1238 | RR | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | $163.87 | |
| E1238 | UE | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | $1,229.05 | |
| E2620 | NU | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | $547.70 | |
| E2620 | RR | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | $54.77 | |
| E2620 | UE | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | $410.79 | |
| E2621 | NU | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | $574.76 | |
| E2621 | RR | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | $57.47 | |
| E2621 | UE | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | $431.08 | |
| K0738 | RR | $32.08 | $32.08 | $32.07 | $32.07 | $32.07 | $32.07 | $32.07 | $32.07 | $32.07 | $32.07 | $32.08 | $32.07 | |
| L2232 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | $78.20 | ||