DMEPOS, orthotics and prosthetics billing
DMEPOS and O&P billing where documentation comes first
DMEPOS billing covers durable medical equipment, prosthetics, orthotics and supplies, reported with HCPCS Level II codes. Payment depends heavily on documentation from the ordering practitioner, supplier enrollment and accreditation, and — for some items — prior authorization.
Built for
- Orthotics and prosthetics clinics
- DME suppliers
Where DMEPOS revenue usually gets stuck
- Documentation from referrers
- Orders and medical records must support each item before billing.
- Prior authorization
- Certain items require prior authorization before delivery.
- Modifiers
- Item-specific modifiers (for example, side of body and documentation-attestation modifiers) are required.
What we handle for you
The services that apply to DMEPOS practices, and what each one means in practice.
| Service | For DMEPOS practices |
|---|---|
| Eligibility, benefits and prior authorization | Prior authorization for items on payer lists. |
| Credentialing, payer enrollment and contracting | Supplier enrollment with payers. |
| Denial prevention and appeals | Documentation-related denials. |
Claims, coding and authorization details that matter
- HCPCS Level II
- Orthotics and prosthetics are reported with L-codes; specificity and modifiers drive payment.
Our DMEPOS billing workflow
- 1
Order, document, authorize, deliver, bill
Payer coordination
- Medicare DMEPOS claims are processed by DME Medicare Administrative Contractors, separate from Part B professional claims.
Compliance notes
- Coding statements on this page are general guidance; final code selection depends on documentation and current payer policy.
DMEPOS, orthotics and prosthetics billing: questions we hear
Do you handle supplier enrollment?
We will confirm DMEPOS enrollment scope during the consultation.
Related specialties
Primary sources
Content last reviewed . Payer rules change; this page is general information, not legal or coding advice for a specific claim.
Let's look at your DMEPOS revenue cycle
Tell us where payments are getting stuck. In 20 to 30 minutes we'll show you what we'd check first, and tell you plainly if we can help.
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