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CHA Issues Summary of DMEPOS Proposed Rule

For CEOs, CFOs, finance & reimbursement staff, post-acute care staff, case managers

CHA has issued a detailed summary, prepared by Health Policy Alternatives, of the proposed rule updating payment methodologies for the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule for calendar year 2021, as well as Healthcare Common Procedure Coding System (HCPCS) issues.

The Centers for Medicare & Medicaid Services (CMS) has also announced changes to the 2021 DMEPOS competitive bidding program, which will be limited to off-the-shelf knee and back braces.   

The summary details methodologies for adjusting the Medicare DMEPOS fee schedule using information from the Medicare DMEPOS competitive bidding program. In addition, it establishes application submission and evaluation processes and other procedures related to the HCPCS Level II code application and procedures for making benefit category and payment determination for new items and services.

CMS also proposes to classify continuous glucose monitors as durable medical equipment under Medicare Part B and establish fee schedule amounts for these items and related supplies and accessories. 

Comments on the proposed rule are due to CMS by 2 p.m. (PT) on Jan. 4, 2021.