CMS provides DMEPOS updates
Device Regulation Alert: Safety, Compliance and Reimbursement News, May 26, 2008
CMS issued a flurry of announcements concerning the competitive bidding program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). The bidding program is effective July 1 in 10 communities.
The new developments include:
- Winning suppliers announced: In a press release, CMS announced the names of 325 suppliers that have contracted with Medicare under the bidding program to provide medical equipment and supplies to Medicare beneficiaries in the bidding areas.
- Accreditation deadline extended: Suppliers who want to participate in the net round of bidding for the program have more time to apply for accreditation. Suppliers must be accredited to participate and those who have at least applied for accreditation by July 21 (will qualify to submit bids. CMS extended the previous May 14 deadline because many suppliers in the 70 metropolitan statistical areas to be included in round two of the bidding program haven’t yet applied for accreditation. Suppliers must be fully accredited by January 14, 2009, to be awarded a contract.
- Payment for complex rehabilitative power mobility device services: CMS announced that in certain cases, Medicare will pay 2008 fee schedule amounts for these power mobility devices in the bidding areas in Round One of the competitive bidding program if certain conditions are met. Qualifying claims are those in which suppliers began furnishing services relating to the device before July 1, 2008, but didn’t deliver the final power mobility device to a beneficiary until after July 1 or later. Affected HCPCS codes include K0856 through K0864. In addition, the physician’s signed order for the device must be dated between April 1, and May 31, 2008, and the supplier must have documentation of a physician’s face-to-face determination of medical necessity made prior to July 1, 2008. Finally, the date of service for the claim should be the date of the physician’s order—not, as is usually required, the date of delivery. Include all accessories on the claim for the power mobility device.
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