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Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service.

The Targeted Probe and Educate program (intensive education to assess provider compliance through up to 3 rounds of review) will restart later. The MACs will continue to offer detailed review decisions and education as appropriate.

Currently, the DME MACs have announced widespread postpayment reviews on the following product categories: 

Product Category


Ankle-Foot Orthoses 

L1902, 1906, L1940, L1970, L1971, L4360, L4361, L4396, L4397

Blood Glucose Test Strips 


Immunosuppressive Drugs 

J7503, J7507, J7518, J7520, J7527

Knee Orthoses 

L1833, L1851

Lower Limb Prostheses 

L5700, L5701

Manual Wheelchairs 


Orthopedic Footwear 

L3040, L3050, L3060

Osteogenesis Stimulators 

E0747, E0748, E0760

Ostomy Supplies 

A4414, A4407-A4409, A4431, A4434, A5081, A5122

Surgical Dressings 

A6010, A6196, A6197, A6212

Therapeutic Shoes for Diabetics 

A5500, A5512-A5514

TLSO/Lumbar Sacral Orthoses 

L0457, L0631, L0650

Urological Supplies 

A4351 – A4353, A4355, A4316


Want to be ‘audit-ready’? The van Halem Group can help! 

From clinical prescreens of your claims to conducting proactive audits on a one-time or monthly basis, we have solutions to ensure your claims are audit ready and meet technical and clinical guidelines. Contact us to learn what our team of experts can do for you!