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
Tag: Durable Medical Equipment
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.
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:
durable medical equipment, prosthetics,orthotics and supplies (dmepos) order requirements
On January 17, 2023, a second Federal Register Notice was published that announced 10 additional orthoses that will require a face-to-face encounter and written order prior to delivery as a condition of payment. Therefore, effective April 17, 2023, a total of 63 items are now on the face-to-face encounter and written order prior to delivery List.
Standardized DMEPOS Written Order/Prescription
Any Medicare provider or supplier that writes DMEPOS orders or prescriptions will now use a standard set of elements that will be applicable to all DMEPOS items.
- Beneficiary name or Medicare Beneficiary Identifier (MBI) Number
- Description of the item
- Quantity, if applicable
- Treating practitioner name or National Provider Identifier (NPI)
- Date of the order
- Treating practitioner signature
The treating practitioner must submit the complete written order to the supplier prior to submitting a claim for Medicare payment.
A successful 2023 starts with ensuring your clinic or ASC has the best DME SaaS technology
Healthcare leaders recognize patients as their most important area of focus. At the same time, however, overseeing business needs like inventory management, reimbursement, price transparency and staff shortages are top priorities. Significant opportunities exist for orthopedic clinics and ASCs to leverage automation to address these issues – but choosing the right solution can be daunting.
For more information, please click here to read the entire Becker’s article
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