CMS Releases Off-The-Shelf Orthotic HCPCS Codes

The Centers for Medicare & Medicaid Services released the 2012 Healthcare Common Procedure Coding System (HCPCS) codes for off-the-shelf (OTS) orthotics usually covered under the Social Security Act.

OTS orthotics require minimal self-adjustment and do not require expertise in trimming, bending, molding, assembling or customizing by a certified orthotist in order to fit an individual.

If an HCPCS code may by assigned to an OTS orthotic, it does not imply any type of health insurance coverage. Subsequent coding updates to the OTS list will be included in program instructions. OTS orthotics are also included as a category subject to competitive bidding, however, CMS has not determined the schedule for bidding OTS orthotics. CMS will identify specific OTS orthotic codes that may be included in a competitive bidding program through other means.

CMS will be accepting electronic comments on the list of OTS HCPCS codes through Thursday, March 8. Comments may be submitted via email to OTSComments@cms.hhs.gov.

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