PINs and reimbursement schedule for offloading devices
Last updated on July 30, 2024To print this page, press CTRL+P
Use the appropriate Product Identification Numbers (PINs) on all applications and invoices. For additional information about reimbursement for offloading devices refer to the PharmaCare Prosthetic and Orthotic Policy Manual, Section 5.9.6.
| PIN | Description | Maximum reimbursement | Quantity limit |
|---|---|---|---|
| 77123560 | Orthotic insert | $675.00 | One pair covered every 36 months |
| 77123561 | Orthotic footwear | $350.00 | One pair covered every 12 months |
| 77123562 | Orthotic cover | $75.00 | Four/per foot every 12 months |
| PIN | Description |
|---|---|
| 77123563 | Repairs/adjustments under $400.00 |
| 77123564 | Repairs/adjustments over $400.00 |