On September 8, 2016, the Centers for Medicare & Medicaid Services (CMS) announced the single payment amounts (SPAs) for Round 1 2017 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program and began offering contracts to successful bidders.
CMS is required by law to recompete contracts under the DMEPOS Competitive Bidding Program at least once every three years. The Round 1 Recompete contract period expires on December 31, 2016. Round 1 2017 contracts are scheduled to become effective on January 1, 2017. CMS plans to announce the contract suppliers this fall.
TWO IMPORTANT UPDATES:
- Healthcare Common Procedure Coding System (HCPCS) code E0147 (walker, heavy duty, multiple braking system, variable wheel resistance) has been removed from Round 1 2017 of the DMEPOS Competitive Bidding Program.
- If you are being offered a contract for furnishing items in the Standard Mobility Equipment and Related Accessories product category, you should be aware that the following items were reclassified to the capped rental payment class effective July 1, 2016, in accordance with a final rule published on December 2, 2013 (78 FR 72224):
E0140 E0149 E0985 E1020 E1028 E2228 E2368
E2369 E2370 E2375 K0015 K0070 E0955 E0197
The SPAs calculated for these items have been established in accordance with regulations at 42 CFR 414.408(h)(1), whereby payment for capped rental DME is made in an amount equal to 10 percent of the SPA for purchase of new equipment for each of the first three months, and 7.5 percent of the SPA for purchase of new equipment for months 4 through 13.