L3000-L3030 Foot Orthotics
Jeremy Sprouse
Description
Collection
Title:
L3000-L3030 Foot Orthotics
Creator:
Jeremy Sprouse
Date:
2/28/2006
Text:
The general consensus was, foot orthotics are not covered, unless it is an
integral part of a leg brace, or unless it is prescribed as part of
therapeutic footwear plan. Several others were interested in the
reimbursement rate. In Region C the allowable for L3020 is $321.18. Medicare
description of L3020, and L3030 are reversed. L3020 is a prefab arch
support , while L3030 is the custom arch support. However; Medicare pay's
more for the L3020 than the L3030 because they never got their fee schedule
straightened out. I don't recall the allowable for the L3030 with Medicare
but it was much less. All other insurances pay more for the L3030 (as it
should be) since it is a custom arch support. My typical fee for other
insurance companies is $350.00, and this seems to be normal allowable with
them. Medicaid no longer covers them in SC. Several people wrote back
stating they were still covered for kids under 21. Not in SC, I called SC
Medicaid last week about a couple kids needing foot orthotics. The codes for
foot orthotics has been deleted all together from the supplier manual and
therefore are not covered for anyone, including diabetics and kids.
I am still a little perplexed about Medicare, they haven't stopped paying
for L3020, even if DM isn't a diagnosis. And like I said in my earlier post,
I was told by Medicare they were still covered. I believe I'll have to give
them a call tomorrow and double check. That's one of the joy's with dealing
with Medicare. You can call three times and get three different answers. :)
Thanks to all
Jeremy Sprouse CPO
integral part of a leg brace, or unless it is prescribed as part of
therapeutic footwear plan. Several others were interested in the
reimbursement rate. In Region C the allowable for L3020 is $321.18. Medicare
description of L3020, and L3030 are reversed. L3020 is a prefab arch
support , while L3030 is the custom arch support. However; Medicare pay's
more for the L3020 than the L3030 because they never got their fee schedule
straightened out. I don't recall the allowable for the L3030 with Medicare
but it was much less. All other insurances pay more for the L3030 (as it
should be) since it is a custom arch support. My typical fee for other
insurance companies is $350.00, and this seems to be normal allowable with
them. Medicaid no longer covers them in SC. Several people wrote back
stating they were still covered for kids under 21. Not in SC, I called SC
Medicaid last week about a couple kids needing foot orthotics. The codes for
foot orthotics has been deleted all together from the supplier manual and
therefore are not covered for anyone, including diabetics and kids.
I am still a little perplexed about Medicare, they haven't stopped paying
for L3020, even if DM isn't a diagnosis. And like I said in my earlier post,
I was told by Medicare they were still covered. I believe I'll have to give
them a call tomorrow and double check. That's one of the joy's with dealing
with Medicare. You can call three times and get three different answers. :)
Thanks to all
Jeremy Sprouse CPO
Citation
Jeremy Sprouse, “L3000-L3030 Foot Orthotics,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/226199.
