Which HCPCS are Included in Competitive Bidding?

The DMEPOS Competitive Bidding Program for 2021 includes 16 product categories. Two of the new categories directly impact the O&P profession: Off-the-Shelf (OTS) Back Braces and Off-the-Shelf Knee Braces. (The OTS back braces and knee braces are those which require minimal self-adjustment for use and do not require a certified orthotist or other individual with specialized training.)

Within each of these categories, one HCPCS has been identified as the "lead item." The bids for the lead item will be used to calculate the payment amount for all other codes in that category.

The lead item for back braces is L0650 and the other HCPCS included in the category are: L0450, L0455, L0457, L0467, L0469, L0621, L0623, L0625, L0628, L0641, L0642, L0643, L0648, L0649, L0651.

The lead item for knee braces is L1833 and the other HCPCS included in the category are: L1812, L1830, L1836, L1850, L1851, L1852

For a complete listing of product categories and the specific HCPCS included in each, go to the DME Competitive Bid site.