UC DME Program 2026

Amplify Your DME Success

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TLC earns Trust & Loyalty by exhibiting our Commitment to your success and by delivering Tender Loving Care with every interaction.

We understand it is a blessing to have the opportunity to be of service and are grateful for your consideration.

TLC specializes in Urgent Care. Our customizable program addresses the needs of the smallest independent operator to the largest national organization. Our program improves clinical outcomes, enhances patient satisfaction, & increases financial well-being.

TLC solutions include extended terms, factory direct pricing, EMR customization, updated HCPCS codes & fee schedules, optimized revenue from reimbursement, offsets 100% of product cost related to global & unpaid patient AR, provider training & patient education, comprehensive reporting, all crafted to enhance your DME success.

Sean Blackmore Raven Blackmore Mike Nelson Lynne Nelson Kim Mays

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Urgent Care / Work Comp Products TLC products are best in class quality & functionality, are designed to address the unique urgent care work comp injuries and indications commonly treated in urgent care/work comp, are PDAC approved for higher levels of reimbursement from all insurances, are used

by Ortho, and are not sold on Amazon!

Inventory Consignment Terms TLC offers factory direct pricing. All startup inventory is consigned with N180 terms.

Reorders are N90. This allows generation of reimbursement revenue before invoices are due.

All products are guaranteed 100% returnable no restrictions. We even buy back competitor’s products, and donate to charity.

Data Driven Reimbursement Solutions Using your ICD10 & CPT information, we quantify your actual vs. potential DME ancillary revenue, customize your EMR with current HCPCS codes & fee schedules, collaborate with your RCM team to ensure no charting or billing errors, and when you are not reimbursed (global, CMS, unpaid patient AR), credit 100% of product cost.

Clinician Training & Patient Education We offer comprehensive training via virtual or onsite demonstrations supported by tutorial & animated videos addressing indications for use, application instructions, presenting to the patient, and documentation. These tools enhance knowledge for clinicians & patients, while promoting your orthopedic injury management protocols.

Compassionate Care & Financial Hardship Patients ask “will my insurance pay for this”, what will this cost me”. When insurance will not cover the cost of the orthopedic device, we will. This allows your clinicians to dispense based on medical necessity, offering the best patient care possible, removing the barriers created by lack of coverage, with little to no cost for the patient!

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XO Back LSO Cryo

XO Boot Pneumatic

XO Knee ROM Cryo

Indications: Lower back pain, strains and lower back muscle spasms.

Indications: Moderate to severe ankle sprains, stable foot/ankle or tib/fib fractures and foot or toe injuries.

Indications: Sprains or strains of the knee, medial and lateral instabilities,and soft tissue injuries of the knee.

PDAC Approved HCPCS Code: L0642 & L0651

PDAC Approved HCPCS Code: L4361 & L2840

PDAC Approved HCPCS Code: L1833 & L2937

XO Sling Arm/Shoulder

XO Thumb Orthosis

XO Wrist Orthosis

Indications: Immobilization of the shoulder/arm, injuries or instabilities of the shoulder/arm, dislocations and subluxations.

Indications: Sprains and strains, scaphoid injuries, carpal tunnel syndrome, gamekeeper’s thumb, and de quervain’s syndrome.

Indications: Sprains and strains, carpal tunnel syndrome, and distal/ radial fractures.

PDAC Approved HCPCS Code: L3670

PDAC Approved HCPCS Code: L3809 & L3995

PDAC Approved HCPCS Code: L3809 & L3995

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Product & HCPCS Code XO Back LSO Cryo

L0651 L0642 & L0651

XO Boot Pneumatic

L4361 & L2840

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ICD10 #

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ICD10 Description

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DME Quick Reference Guide Ankle Support L1902

XO Thumb Orthosis L3809 & L3995

XO Knee Immobilizer L1830

XO Back LSO Cryo L0642 & L0651

XO WHTO Undersleeve L3995

XO Knee ROM Cryo L1833 & L2937

XO Boot Pneumatic L4361 & L2840

XO FX Orthosis L3807 & L3995

XO AFO Undersleeve L2840

XO Wrist Orthosis L3908 & L3995

Shoe Surgical L3260

XO WHO Undersleeve L3995

XO Finger Orthosis L3927

Crutches E0114

XO Sling Arm/Shoulder L3670

Cervical Collar L0172

For more information and training Scan the QR Code to access Quick Fit DME Training Videos.

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XO KO Undersleeve L2397

Elbow Strap A4567

“This orthopedic device was crafted specifically for your injury.

It will help you feel better faster and heal more quickly.”

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Formulary

HCPCS Code

Fee Schedule

XO Ankle Support

L1902

$125.00

XO Back LSO Cryo

L0642 & L0651

$670.00

XO Boot Pneumatic

L4361 & L2840

$415.00

Cervical Collar Semi-Rigid

L0172

$190.00

Crutches

E0114

$75.00

Elbow Strap Gel

A4467

$25.00

XO Finger Orthosis

L3927

$45.00

L3807 & L3995

$335.00

XO Knee Immobilizer

L2397

$225.00

XO Knee ROM Cryo

L1833 & L2397

$670.00

Shoe Surgical

L3260

$25.00

XO Sling Arm Shoulder

L3670

$150.00

XO Thumb Orthosis

L3809 & L3995

$335.00

XO Wrist Orthosis

L3809 & L3995

$175.00

XO FX Orthosis

HCPCS Codes provided align with PDAC approval and the Fee Schedules listed align with CMS charge values.

It is the clients responsibility to determine which codes and fee schedules are used during billing.

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DME Billing Success Trends Year

Units Billed

Amount Billed

Amount Paid

Paid Ratio

Spend Value

COGS Ratio

2023

3,989

$346,637

$120,304

34%

2.2X

45%

2024

9,209

$1,415,467

$728,631

51%

5X

20%

2025

12,313

$1,893,047

$1,004,117

53%

5X

19.5%

2024 DME FINANCIAL ANALYSIS

2023 DME FINANCIAL ANALYSIS

2025 DME FINANCIAL ANALYSIS

HCPCS

Product

QTY

Charged

Paid

Open A/R

HCPCS

Product

QTY

Charged

Paid

Open A/R

HCPCS

Product

QTY

Charged

Paid

Open A/R

L4386

Walking Boot Non-Air

806

$144,714.00

$52,181.49

$6,763.61

L1902

Ankle Support

596

$72,072.00

$29,858.11

$55.11

L1902

Ankle Support

670

$78,994.00

$34,547.66

$7,228.89

E0114

Crutches

717

$30,676.00

$12,123.86

$1,447.34

A4565

Arm Sling

215

$4,452.32

$1,288.56

$21.37

A4565

Arm Sling

193

$3,943.08

$954.64

$299.81

A4565

Arm Slings

673

$12,003.56

$3,082.84

($41.58)

L0642

Back Support

414

$130,400.00

$81,681.55

$833.33

L0642

Back Support 642

553

$170,857.12

$113,355.21

$19,678.38

L3908

Wrist Orthosis

575

$42,810.00

$14,322.93

$708.41

L4361

Boot Pneumatic

1515

$460,635.00

$253,096.04

$3,088.93

L4361

Boot Pneumatic

2,135

$647,570.58

$361,924.53

$62,049.30

L4350

Ankle Brace/Stirrup

205

$22,463.00

$8,089.10

$772.12

L2840

Boot Sock

994

$57,304.00

$27,624.70

$435.62

L2840

Boot Sock

1,890

$109,355.52

$52,598.89

$10,870.93

L3260

Post Op Shoe

201

$11,940.00

$1,985.18

$525.18

L0172

Cerv Collar Semi-Rigid

1

$30.00

$30.00

$0.00

L0172

Cerv Collar Med

3

$359.00

$213.57

$107.61

L1830

Knee Immobilizer

126

$15,430.00

$5,006.01

$817.36

E0114

Crutches

818

$108,105.00

$20,909.71

$581.26

E0114

Crutches

932

$131,301.00

$28,118.22

$9,048.30

L0120

Cervical Collar- Soft

10

$452.00

$224.74

$23.38

A4467

Elbow Support

62

$2,450.00

$487.12

$0.00

A4467

Elbow Support

66

$2,530.00

$560.82

$176.68

L1820

Knee Hinged

7

$900.00

$244.61

$0.00

L3927

Finger Orthosis

13

$678.00

$311.20

$0.00

L3927

Finger Orthosis

10

$2,135.00

$1,522.58

$72.94

Finger Splint

841

$29,479.00

$3,001.63

$51.80

$1,984.79

L1902

Ankle Support

7

$840.00

$67.83

$115.66

Q4049

Q4049

Finger Splint

1,045

$35,768.75

$4,510.53

L4360

Walking Boot w/Air

17

$4,800.00

$745.55

$35.00

L3984

FX Bracing Upper Ext

24

$8,300.00

$4,357.36

$0.00

L3984

FX Bracing Upper Ext

4

$1,400.00

$1,093.46

$233.35

L3807

Thumb Orthosis

27

$5,968.00

$1,867.60

$269.57

L1830

Knee Immob

108

$15,900.00

$5,384.46

$349.01

L1830

Knee Immobilizer

128

$17,130.00

$7,315.89

$1,566.88

L3923

Hand Finger Orthosis

120

$13,418.00

$3,785.91

$607.41

L1833

Knee Support

631

$150,661.00

$102,847.00

$1,198.17

L1833

Knee Support

857

$204,355.00

$123,932.67

$31,327.43

L0150

Cervical Collar-Med

2

$314.00

$103.57

$0.00

L3260

Shoe Surgical

397

$15,591.00

$5,201.50

$272.13

L3260

Shoe Surgical

512

$19,760.00

$7,114.71

$1,816.06

L1810

Knee Stab

138

$20,965.00

$10,079.19

$1,226.99

L3670

Sling Arm Shoulder

904

$109,410.00

$57,641.10

$660.00

L3670

Sling Arm Shoulder

1,125

$153,394.00

$91,217.69

$11,867.87

L1906

AFO MultiLig Ank

86

$11,880.00

$4,914.44

$83.86

L3809

Thumb Orthosis

697

$166,780.00

$97,566.30

$664.27

L3809

Thumb Orthosis

546

$132,081.09

$81,505.50

$10,064.07

L3215

Ortho Oxford Ladies Shoe

50

$2,698.00

$892.75

$301.75

L3908

Wrist Orthosis

979

$83,220.00

$37,344.99

$704.81

L3807

TKO

284

$68,626.00

$40,134.91

$7,033.00

L3216

Ortho Ladies Shoe

21

$760.00

$163.86

$0.00

TOTAL

9,209

$1,415,467.32

$728,631.33

$8,915.81

L3908

Wrist Orthosis

1,360

$113,487.68

$53,496.24

$8,096.08

L3219

Ortho Oxford Mens Shoe

19

$1,136.00

$117.86

$71.00

12,313

$1,893,047.82

$1,004,117.72

$183,522.36

L3224

Ortho Oxford Ladies Shoe

2

$98.00

$30.40

$0.00

L3650

Clavicle Fig 8

3

$255.00

$18.89

$0.00 $17.00

A4467

Generic Sleeve

68

$1,337.00

$256.32

A4466

Old Code Generic Sleeve

109

$780.00

$0.00

$60.00

3,989

$346,637.56

$120,304.93

$13,804.06

TOTAL

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TOTAL

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Global Billing Service Program 1. Once the diagnosis is established, determine which DME product to prescribe/dispense and apply to the patient.

2. Complete DME Prescription & Delivery Ticket Form a. Section 2 DME Prescribed (select product(s) dispensed) b. Section 3 DME Product Sticker (place DME stickers on form) c. Section 4 Patient Info (Name, DOB, Sex, Signature, Bill To) d. Section 5 Provider Info (Dx Code, Provider Name, NPI Sign) 3. Submit the completed Delivery Ticket with Chart Notes & Patient Demographics from your EMR. a. Email order-sb@tlcmedical.com b. Save a copy for your records 4. If you have any questions or need any support, please contact: Christine Newman VP of Operations christine@tlcdme.com 1.888.521.8522

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DME Prescription & Delivery Ticket SECTION 1: FACILITY INFORMATION Ph:

Facility Name:

SECTION 2: PRESCRIBED DME INFORMATION XO Ankle Support

Cervical Collar

XO Boot Pneumatic

Knee Immobilizer

XO KO Undersleeve

XO Thumb Orthosis

XO FX Splint

XO Back LSO

Crutches

XO AFO Undersleeve

XO Knee Rom

XO Shoulder/Arm Sling

XO FX Orthosis

XO WHO Undersleeve

SECTION 3: PRODUCT STICKER Please place product sticker(s) here:

SECTION 4: PROVIDER INFORMATION Diagnosis or Dx Code: Provider Name (please print):

NPI#: SECTION 4: PROVIDER INFORMATION Date of Order:

Provider Signature (no stamps):

Length of Need:

SECTION 5: PATIENT INFORMATION Patient Name (print):

Patient Date of Birth:

Right to Choose a Supplier: I understand I may choose any supplier for my durable medical equipment (DME). The clinic, Medtech Enterprises, LLC, or an affiliated third-party administrator (TPA) may provide or coordinate my device for convenience. I am not required to use any specific supplier and may request a referral to another provider. I have chosen to receive my device voluntarily, without pressure or obligation.

Home Environment & Safety: I received my prescribed device(s) and instructions for proper use and home safety, including guidance on pathways, personal limits, and wearing techniques.

Insurance Billing & Financial Responsibility: Medtech Enterprises, LLC, the clinic, and/or TPAs may bill my insurance when applicable. If none are contracted with my plan, or if coverage is denied, I agree to pay for the device. I have been informed of my supplier choice and understand I am responsible for any uncovered or non-covered costs.

Proof of Delivery & Warranty: I confirm receipt of my device(s) and understand it is covered by a 90-day manufacturer warranty against normal-use defects. Misuse or alteration voids this coverage. Returns of unworn devices within 14 days will be credited within 30 days. I am satisfied with the fit and instructions provided.

Text & Electronic Communication Consent: I consent to receive texts, calls, or electronic messages from the clinic, Medtech Enterprises, LLC, or authorized partners regarding my device, insurance, or billing. Standard rates apply. I may opt out anytime by replying “STOP.” Consent is not required for care.

HIPAA Notice: I acknowledge receipt of the Notice of Privacy Practices describing how my protected health information (PHI) may be used for treatment, payment, and operations. A copy is available at patientcare@medtechortho.com.

Supplier Standards: I acknowledge access to the Medicare DMEPOS Supplier Standards available at: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/DMEPOSEnrollment

Insurance

Self Pay

Worker’s Comp

Patient Signature: (or auth rep) Print Name of Authorized Rep:

Relationship to Patient: Date of Delivery: SECTION 6: SUBMISSION

Please fax or email this completed form. Submission MUST INCLUDE Patients Demographics and Chart Notes

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TLC DME Purchase Service Agreement Inventory Terms: Initial inventory will be processed and shipped to each location with N180-day terms. You have a full six months to evaluate all products, gauge patient satisfaction, and receive reimbursement before any payment for the startup inventory is due. Reorders are N90 day terms. Start-up order details are included in Appendix A. You can return anything at any time for any reason for full credit Termination of Agreement: Termination of services & purchases requires a 60-day written notification. If a change in ownership of your clinics takes place the new owners will assume responsibility for all outstanding balances. Any TLC unused, non-logoed products in resalable condition may be returned.

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Title

Signature

Date

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