Tag: Medicare

Updates to the Master List and the Required Prior Authorization List

Posted on by DME INFO

CMS announced in the Federal Register on 1/13/2026 updates to the Master List and the Required Prior Authorization List.  The Master List update includes the addition of 18 HCPCS codes effective 4/13/2026.

The Required Prior Authorization List update includes the selection of seven HCPCS codes. The additional selections include certain orthoses and pneumatic compression device items. Prior authorization as a condition of payment begins nationwide 4/13/2026 for the newly added codes.

See the Policy Groups section for more information.
See the full list of codes on the Required Prior Authorization List (PDF)
See the full list of codes on the Master List (PDF)

Source: https://www.federalregister.gov/documents/2026/01/13/2026-00487/medicare-program-updates-to-the-master-list-of-items-potentially-subject-to-face-to-face-encounter

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program – Updates and Important Information

Posted on by DME INFO

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.

Next Round Timeline

To ensure bidders are prepared for the next round, CMS has announced the following next steps for the program:

December 2025

CMS begins pre-bidding supplier awareness program 

Late Spring/Early Summer 2026

CMS announces specific dates for registration and bidding

CMS announces lead items for the DMEPOS CBP product categories and number of contracts to award for each product category

CMS begins bidder education program

Late Summer/Early Fall 2026

Bidder registration period to obtain user IDs and passwords begins. Bid window opens.

Late Summer/Early Fall 2027

Contracts awarded and single payment amounts announced

Beneficiary education begins

No Later Than January 1, 2028

Start of Next Round – Contracts and single payment amounts (SPAs) in effect

Six-month transition period begins for beneficiaries to switch to contract suppliers

For more information please visit   Competitive Bidding Updates

Reference: https://www.cms.gov/newsroom/fact-sheets/durable-medical-equipment-prosthetics-orthotics-supplies-competitive-bidding-program-updates

Trump Administration Proposes Significant Updates to Disclosure Requirements to Make Health Care Prices Clear, Accurate, and Actionable for Americans

Posted on by DME INFO

The Centers for Medicare & Medicaid Services (CMS), in partnership with the Department of Labor and the Department of the Treasury (collectively, the Departments), today jointly proposed major updates to the historic health care price transparency rules established during President Trump’s first term.

“Americans have a right to know what health care costs before they pay for it,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “This proposal delivers real transparency by turning hidden pricing into clear, usable information—so families can make informed decisions and hold the system accountable. It fulfills President Trump’s commitment to put patients, not special interests, first.”   For More Information, PRICE TRANSPARENCY

Reference: https://www.cms.gov/newsroom/press-releases/trump-administration-proposes-significant-updates-disclosure-requirements-make-health-care-prices

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program – Updates and Important Information

Posted on by DME INFO

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

Reference:https://www.cms.gov/newsroom/fact-sheets/durable-medical-equipment-prosthetics-orthotics-supplies-competitive-bidding-program-updates

Medicare Competitive Bidding Announcement

Posted on by DME INFO

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:

CMS Competitive Bidding

Reference: https://www.cms.gov/medicare/payment/fee-schedules/dmepos-competitive-bidding