2026 Medicare DMEPOS Fee Schedule Updates

What You Need to Know

Last week, the Centers for Medicare & Medicaid Services (CMS) released the 2026 DMEPOS fee schedule updates, which include the following changes: 

For devices not previously subject to competitive bidding, fees will increase by 2.0%.

• For former competitive bidding items (i.e., off-the-shelf knee and spinal orthoses) Fees will increase by 2.8% for patients who live in a former Competitive Bidding Area. Fees will increase by 2.7% for patients who live in an area that was not part of Competitive Bidding Round 2021 (Note: The CMS announcement states these fees will increase by 2.8%, but the posted fee schedule only reflects a 2.7% increase).
• Labor codes for orthotic claims (L4205) and prosthetic claims (L7520) will increase by 2.7%.
• Rural fee schedule amounts are determined by the specific zip code of the rural area, but most increases this year are about 2.3%.

While CMS did not reference sequestration, it is our understanding that Medicare will continue to deduct a sequestration amount of 2% from final Medicare payment as in years past.

What This Means for You

Make sure that you understand the impact of the 2026 fee schedule adjustments on your business. Be aware that the annual update amount for some of the same orthotic/bracing codes might be different depending on where your patient lives (e.g., a former Round 2021 Competitive Bidding Area, a non-CBA area, and a rural area).

While Medicare proposed several new L-codes and payment determinations for both orthotic and prosthetic devices in the 2025 second-half coding cycle, none of those new codes or payment amounts are yet included in the 2026 fee schedule. This means that those codes and fee schedule amounts will get added in future quarterly fee schedule updates once Medicare finalizes them. We will update you regarding any such changes as that information becomes available.

For more information on the 2026 DMEPOS fee schedule, you can review Transmittal 13519 of the CMS Manual System. You can also access the different files containing the 2026 fee schedule updates here.