Are splinting and casting codes included in the DMEPOS fee schedule for work comp?

ANSWER: As of 4/1/2014, the workers' comp DMEPOS fee schedule includes splinting and casting codes. These splinting and casting codes are commonly referred to as Q codes.

Prior to April 1st, splinting and casting was reimbursed using the physician fee schedule of the OMFS. On April 1st, Medicare folded splinting and casting codes into its DMEPOS fee schedule, and the DWC adopted that change for dates of service as of April 1st.

From the Update Table:

Casting and Splint Supplies: DMEPOS Fee Schedule

Remember,  that DMEPOS is reimbursed at 120% of the CMS Medicare DME fee schedule, therefore, incorporation of the splinting and casting codes into the DMEPOS fee schedule resulted in reimbursements increasing 20% for dates of service as of 4/1/2014.

Example: 3 Q Codes

In the examples below, the change is reflected in the DaisyBill OMFS Calculator: the first example shows reimbursement for 3 Q codes as 1/1/2014 while the second example shows reimbursement for the same 3 Q codes as of 4/1/2104.

DaisyBill OMFS Calculator

DaisyBill OMFS Calculator

Division of Workers’ Compensation Websites

Official Medical Fee Schedule

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