The Centers for Medicare & Medicaid Services (CMS) is making some important changes in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) so that we can protect the Medicare Trust Funds and lower copays for beneficiaries. For more details, refer to the Calendar Year (CY) 2026 Home Health Prospective Payment System Final Rule (CMS-1828-F) displayed in the Federal Register on November 28, 2025. CMS Competitive Bid Updates
DMEPOS Competitive Bidding Program (CBP)
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) required
Medicare to replace the fee schedule payment methodology for selected DMEPOS items with a
competitive bidding program implemented in areas throughout the country. The DMEPOS CBP
helps Medicare establish sustainable prices, saves money for beneficiaries and taxpayers, and
limits fraud, waste, and abuse in the Medicare program. In addition to the cost savings, there
are several beneficiary protections that help to guarantee access to competitively bid DMEPOS
including requiring contract suppliers to provide equal access to all DMEPOS items and
services included in the supplier contract to every beneficiary residing in the competitive bidding
area. Please click this link and go to page 21 for more information. CMS Competitive Bidding
New HCPCS Updates
October 2024 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes and Modifiers
The following information is based on the October 2024 Healthcare Common Procedure Coding System (HCPCS) file. There are updates that will be effective October 1, 2024. It’s important to remember that the appearance of a HCPCS code is not an indication of coverage by the DME MAC.
Please click here for the HCPCS codes that will be effective October 1, 2024.
Delay of Prior Authorization Requirements for Osteogenesis Stimulators: 08/08/2024
Effective immediately, CMS will delay phase one for prior authorization of Osteogenesis Stimulators HCPCS codes (E0747, E0748, and E0760) until September 17, 2024. Previously, these codes were scheduled to be added to the Required Prior Authorization List in the states of California, Florida, Pennsylvania, and Ohio on August 12, 2024. Phase two for prior authorization of osteogenesis stimulators will remain the same, and prior authorization will be required for all states beginning November 12, 2024. For more information, please visit CMS Delays Prior Auth
Medicare Competitive Bidding AnnouncemeNT
All Medicare Round 2021 Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) Competitive Bidding Program (CBP) Contracts for Off-the-Shelf (OTS) back braces and OTS knee braces expire on December 31, 2023. Starting January 1, 2024, there will be a temporary gap in the DMEPOS CBP.
The Centers for Medicare & Medicaid Services plans to conduct bidding for the next round of the DMEPOS CBP after going through notice and comment rulemaking to further strengthen the DMEPOS CBP.
For additional information on the gap period, please see the Temporary Gap Period (PDF) fact sheet and continue to monitor the CMS.gov and Competitive Bidding Implementation Contractor (CBIC) websites for updates.
Please click this link for more information:
DME INFO 