CMS announcement for durable medical equipment suppliers

The Centers for Medicare & Medicaid Services (CMS) announced updated guidance regarding several emergency waivers related to Medicare and Medicaid policies and regulatory updates during this pandemic for durable medical equipment suppliers. The CMS very likely will continue to announce supplemental guidance on the blanket waivers. Here we have a detailed summary of the relevant […]

CY 2020 Update for Durable Medical Equipment

CMS has revised previous updates of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule on January 3, 2020, to reflect an updated Change request (CR) that corrected the CY 2020 maintenance and servicing fee for certain oxygen equipment to $73.02 in the CR’ s business requirement 11570.9. The transmittal number, CR release […]

Prior Authorization Process for DME during COVID-19 – Provider Burden Relief FAQs

The importance of medical review activities to CMS’ program integrity efforts, CMS will stop exercising enforcement discretion for the Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items beginning on August 3, 2020, regardless of the status of the public health emergency. Is CMS suspending most Medicare Fee-For-Service (FFS) medical […]

DME Supplies for Children with Disabilities

There might be a need for medical equipment or supplies for children with disabilities or having special health care needs. Once you identify your child’s needs then, you will be thinking about the different options as well as the ways to pay for durable medical equipment. However, insurance is one of the solutions for your […]

DME Supplies: CMS Flexibilities to Fight COVID-19

From the beginning of the outbreak, the government has issued an uncommon range of temporary regulatory exemption as well as new rules and regulations in order to solidify the American healthcare system with the utmost flexibility to fight with the Novel Coronavirus (COVID-19) pandemic. These temporary changes in the guidelines will apply all over the […]

How to order DMEPOS items correctly?

As per the Medicare Program Integrity Manual, Chapter 5 (Items and Services Having Special DME Review Considerations), before you dispense any DMEPOS item to a beneficiary, you need to have an order from the treating physician. Please note that this article is intended for suppliers billing Durable Medical Equipment (DME) MACs for Durable Medical Equipment […]

Physician Liability for DMEPOS Medical Necessity

The Medicare program only pays for health care services that are medically necessary. In determining what services are medically necessary, Medicare primarily relies on the professional judgment of the beneficiary’s treating physician, since he or she knows the patient’s history and makes critical decisions, such as admitting the patient to the hospital; ordering tests, drugs, […]

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