DMEPOS rates drop significantly, reflecting competitive bidding amounts

CMS has updated the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule amounts, based on information from the DMEPOS Competitive Bidding Program. The new payment rates for many items, from walkers to power wheelchairs to hospital beds are dropping by half or more in both urban and rural settings.

Competitive bidding

The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) established the competitive bidding program for certain items and services. Single payment amounts, determined by bids submitted by DMEPOS suppliers, replaced current fee schedule payment amounts in an effort to set more appropriate payments. These payments are intended to reduce out-of-pocket expenses, save money for the Medicare program, and ensure access to items and services. Bidding programs are established in 99 metropolitan statistical areas in the U.S.

July updates

The adjustments to the fee schedule began on January 1, 2016, establishing a payment rate comprised of an equal blend of current and adjusted rates, providing for a six-month transition period during which CMS assessed health outcomes and access to services. The July updates include fully adjusted rates, which include rate revisions updated to reflect additions and recompeted contracts under the bidding program.