Month: February 2019

  • DME Billing
    Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Update 2019

    Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Update 2019

    CMS happen to announce in the year 2019 about Medicare fee schedule rates for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The 2019 update factor is 2.3%, although other pricing policies are applied in specific circumstances. The DMEPOS and PEN fee schedule files contain the Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the adjusted fee schedule amounts under Section 1834(a)(1)(F) as well as codes that are not subject to the fee schedule Competitive Bidding Program adjustments. For CY 2019, the following Fee Schedule Adjustment Methodologies apply and fee schedule amounts are based on the area in which the items and services are furnished. Fee Schedule Amounts for Areas within the Contiguous United States To determine the adjusted fee schedule amounts, the average of Single Payment Amounts from CBPs located in eight different regions of the contiguous United States are used to adjust the fee schedule amounts for the states located in each of the eight regions. These Regional SPAs or RSPAs are also subject to a national ceiling 110 percent of the average of the RSPAs for all contiguous states plus the District of Columbia) and a national floor (90% of the average of the…

    Read More »