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Official Description

Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories
Short Descr Upper extremity rehab
Coverage Carrier Priced
Pricing Indicator(s) 36 – Supplies And Surgical Dressings - Capped rental DME (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS D1E – Other DME
TOS Code(s) R – Rental of DME
Added Date 4/1/2024
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE Not applicable/unspecified.
MUE 1
OTS Orthotic No
Date
Action
Notes
2025-01-01 Added First appearance in codebook.
2024-10-01 Note Payment change (MOG, pricing indicator codes, anesthesia base units, Ambulatory Surgical Centers)
2024-04-01 Added Code added.
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