Jurisdiction A DME MAC
2008 DMEPOS/PEN Fee Schedule Updates
Inclusion of a fee schedule amount for an item does not necessarily indicate coverage
Therapeutic Shoes
HCPCS	Mod1	Mod2	CT	DC	DE	MA	MD	ME	NH	NJ	NY	PA	RI	VT
A5500			$63.58	$63.58	$63.58	$63.58	$63.58	$63.58	$63.58	$63.58	$63.58	$63.58	$63.58	$63.58
A5501			$190.71	$190.71	$190.71	$190.71	$190.71	$190.71	$190.71	$190.71	$190.71	$190.71	$190.71	$190.71
A5503			$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28
A5504			$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28
A5505			$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28
A5506			$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28
A5507			$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28	$28.28
A5512			$25.94	$25.94	$25.94	$25.94	$25.94	$25.94	$25.94	$25.94	$25.94	$25.94	$25.94	$25.94
A5513			$38.71	$38.71	$38.71	$38.71	$38.71	$38.71	$38.71	$38.71	$38.71	$38.71	$38.71	$38.71