Prosthetics & Orthotics, Prosthetic Devices, & Therapeutic Shoes
Prosthetics & Orthotics, Prosthetic Devices, & Therapeutic Shoes
Durable Medical Equipment, Prosthetic Devices, Prosthetics, Orthotics and Supplies (DMEPOS) includes items falling under the benefit category for prosthetic devices defined in section 1861(s)(8) of the Social Security Act (the Act) as well as the benefit category for leg, arm, back, and neck braces (orthotics), and artificial legs, arms, and eyes (prosthetics), including replacements if required because of a change in the patient’s physical condition in accordance with section 1861(s)(9) of the Act. Also, while therapeutic shoes and inserts for individuals with diabetes aren’t paid under the DMEPOS benefit, they’re paid under Medicare Part B and claims for these items are process by the DME Medicare Administrative Contractors (MACs).
This page provides details about these devices and how CMS determines whether items or services can be categorized as a prosthetic, orthotic, prosthetic device, or a therapeutic shoe.
Certain laws, regulations, and Medicare program manuals are often mentioned on this page. View the “Related Links” section.