DME Durable Medical Equipment
HME - Hospital Medical Equipment
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UltraMotion CPM Manufactured by Orbital Industries
** On April 25th 2006 Medicares HCPCS Coding Committee decided to award The UltraMotion CPM a Permanent HCPCS Code. The Permanent Code is E 0936 and it was issued on October 26, 2006. It will take effect on January 1st, 2007 ** |
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Medicare HCPCS Committe Letter
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Medicare Letter - Permanent Code E 0936
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Continuous passive motion (CPM) is considered medically necessary to improve range of motion (ROM) in any of the following situation. It should be viewed as an adjunct to standard postoperative physical therapy regimens for minimum of 21 days.
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* Following a total ankle arthroplasty (TAA) or TAA revision
* Following a foot or ankle ligament repair
* During the non-weight-bearing period following articular cartilage grafting procedures; (e.g., ACI, osteochondral implant)
* During the non-weight-bearing period following a tendon repair procedure;
* Subsequent to arthroplasty or the release of an arthrofibrosis of the elbow or knee, ankle, shoulder, wrist, or hand. (Examples include: elbow arthroplasty, rotator cuff repair or arthroplasty or metacarpal joint phalangeal arthroplasty.)
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(E-0936) -- HCPCS/ CPT CODE $24.00- $49.00 = Reimbursements rate average ranges. Example of variations in allowable amounts depends on region:
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- $16.95 ODJFS Allowed Amount
- $38.14 OBWC Allowed Amount
- $26.27 Palmetto GBA ***
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ULTRAMOTION CPM
DME/HME REIMBURSEMENT MODEL
HCPCS CODE E 0936
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Cost Equipment
(single unit purchase) |
$2990.00 |
Charge per day*
Using Medicare Allowable |
$26.27 |
Using Medicare Allowable
Number of user days 21 **
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21 |
*Number of days used --
*Varies depending on Insurer
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21
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| Revenue per day |
$26.27 |
Revenue per week - 7 days
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$183.89 |
Revenue per Patient
21 days of usage
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$551.67 |
Number of weeks to recover cost of equipment
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16.3 Weeks
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Number of Patients
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5.9
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Revenue Per Year - 1 Piece of equipment
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$9562.28
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ULTRAMOTION CPM
PHYSICAL THERAPY REIMBURSEMENT
HCPCS CODE E 97110 |
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Palmetto GBA Part B Carrier Definition of Terms for Physical Medicine / Rehabilitation Service
Provider: PM&R Services may be billed under one of three different practitioner benefits:
• Physicians, as their own services, or as services furnished incident to their services.
• Physical Therapists in an Independent Practice.
• Occupational Therapist in an Independent Practice.
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(E-97110) - HCPCS/ CPT CODE: Therapeutic procedures, One or more areas, and each 15 minutes of therapeutic exercise to develop strength and endurance, range of motion, and flexibility.
(E-97110) - HCPCS/ CPT CODE $24.00- $49.00 = Reimbursements rate average Ranges. Example of Variations in Allowable Amounts:
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- $26.27 Palmetto GBA Allowed Amount
- $16.95 ODJFS Allowed Amount
- $38.14 OBWC Allowed Amount
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ULTRAMOTION CPM
PHYSICAL THERAPY REIMBURSEMENT MODEL
HCPCS CODE E 97110 |
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Cost Equipment
(single unit purchase) |
$2990.00 |
| Charge per day* 15 Minute Using Medicare Allowable |
$26.27 |
Number of user sessions a day
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4 |
Number of days used
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5
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| Revenue per day |
$105.08 |
Revenue per week - 7 days
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$525.40 |
Revenue per month
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$2101.60 |
Revenue per year
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$25,219.20
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Number of weeks to recover cost of equipment
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5.7 Weeks
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First Year Profit less cost of equipment
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$22,229.20
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REIMBURSEMENTS
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THE ORBITAL WORKOUT - (Foot & Ankle Exerciser)
Continuous Active Motion - CAM,
HCPCS CODE (E 0936) EXERCISE EQUIPMENT
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| REIMBURSEMENT MODEL - THE ORBITAL WORKOUT |
Cost Equipment
(single unit purchase) |
$29.90 |
Charge per day*
Using Medicare Allowable |
$26.27 |
Using Medicare Allowable
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Varies
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*Number of days used --
*Varies depending on Insurer
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Varies Example 21 days
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| Revenue per day |
$26.27 |
after 2'd day equipment is purchased
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$29.90 |
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* If you are a DME/HME:
Contact Us for Discounted Pricing. |
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