These adjustments result in an increase in fee schedule amounts ranging from $6.72 to $8.19 in former competitive bidding areas, $5.17 to $5.43 in other non-rural areas, and $4.41 to $6.82 in noncontiguous and rural areas. Effective for claims with dates of service on or after April 1, 2021, the fee schedule amounts for HCPCS codes E0424, E0431, E0433, E0434, E0439, E0441, E0442, E0443, E0444, E0447, E1390, E1391, E1392, E1405, E1406, and K0738 are adjusted to remove a percentage reduction necessary to meet the budget neutrality requirement previously mandated by section 1834(a)(9)(D)(ii) of the Act. Effective April 1, 2021, section 121 of this Act eliminates the budget neutrality requirement set forth in section 1834(a)(9)(D)(ii) of the Act for separate classes and national limited monthly payment rates established for any item of oxygen and oxygen equipment using the authority in section 1834(a)(9)(D)(i) of the Act. The Consolidated Appropriations Act of 2021 (Public Law 116-260) was signed into law on December 27, 2020. When to Use Fee Schedule, Create New Fee Schedules, Attach Fee Schedules to Employer or Patient, Edit Existing Fee Schedules, Print Fee Schedule Reportįee schedules are used to charge fees that differ from the practice's standard fees.Consolidated Appropriations Act of 2021 Changes to the Oxygen and Oxygen Equipment Fee Schedule Amounts in the Medicare DMEPOS Fee Schedule There are two types of fee schedules - insurance fee schedules and patient fee schedules. Insurance fee schedules are used when a practice is contracted with an insurance company, often referred to as in network, contracted, or PPO. Patient fee schedules are used when a patient does not have insurance and the practice wants to charge them a different fee than the master fee, often referred to as in-house discount plan for cash patients.Fee Schedules attached to the patient override all other fee schedules/fees.Fees that are not included in a fee schedule will be charged the rate from the Master Standard fee.Fee Schedules attached to the employer override the Master Standard fees. With a fee schedule, the contracted fee will reflect on production. If the practice wants to reflect the full master standard fees on production, a coverage book is recommended.
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