Jurisdiction A DME MAC
4th Quarter 2005 DMEPOS/PEN Fee Schedule Updates
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
L6694 $632.69 $563.43 $563.43 $632.69 $563.43 $632.69 $632.69 $535.88 $535.88 $563.43 $632.69 $632.69
L6695 $527.21 $469.51 $469.51 $527.21 $469.51 $527.21 $527.21 $446.56 $446.56 $469.51 $527.21 $527.21
L6696 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59
L6697 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59 $1,035.59
L6698 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91 $398.91