Durable Medical Equipment (DME) Center
Spotlights
- The Centers for Medicare & Medicaid Services has furnished the list of 2012 HCPCS codes initially designated as Off-The-Shelf (OTS) orthotics. View the list of OTS Orthotics . (Posted 2/9/2012)
- The Centers for Medicare & Medicaid Services has announced the timeline for bidding and initiated a comprehensive supplier education program leading up to the bidding period for the Round 2 and National Mail-Order competitions of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program. View and .
- Medicare is finalizing a provision to establish a 3-year minimum lifetime requirement (MLR) for equipment to be considered durable for purposes of payment under the benefit category for Durable Medical Equipment (DME) in the End-Stage Renal Disease Prospective Payment System Final Rulemaking CMS-1577-F [Published: November 10, 2011] - [Text version], [PDF version] (updated 11/30/2011).
- Blood Clotting Factor Furnishing Fee
- Medicare DMEPOS Competitive Bidding Program Round 2 product categories and have been announced. View and . (Posted 08/19/2011)
Medicare Learning Network (MLN) Spotlights
Go to the Spotlight page for the latest MLN products and announcements! Check it often!
Important Links
Billing / Payment
Payment
Enrollment / Participation
- Medicare Provider-Supplier Enrollment
- - which suppliers accept assignment for DMEPOS by state
Medicare Prescription Drug Coverage
- Information for Providers
Policies & Regulations
- Quarterly Provider Updates
- Medicare Program; Payment for Respiratory Assist Devices With Bi-Level Capability and a Backup Rate (CMS-1167-F) [PDF, 85KB] and (published in the Federal Register on January 27, 2006)
Medicare Secondary Payer
- Medicare Secondary Payer & You
- 100-05 Medicare Secondary Payer Manual
- Coordination of Benefits - General Information
DME Medicare Administrative Contractor (MAC) Websites
Contacts
- DME MAC Contacts [PDF, 14KB]
- SADMERC Helpline: (877) 735-1326 --- Who you should contact to determine which HCPCS code to use for billing
- CMS Regional Offices
- Contacting the COB Contractor
Competitive Bidding
CMS Manuals & Transmittals
- Manuals
- Internet-Only Manuals (IOMs)
- DMEPOS Transmittals
- CMS Program Memoranda
- Chapter 15 – Covered Medical and Other Health Services [PDF, 1MB] (Chapter 15, Section 110)
- Chapter 20 - Medicare Claims Processing Manual [PDF, 428KB] (Chapter 20 - Durable Medical Equipment, Prosthetics, Orthotics and Supplies)
- To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU listserv from the CMS Mailing Lists.
- National Coverage Determinations (NCD) Manual - Pub. 100-03
DME MAC Supplier Manuals
National Provider Identifier (NPI)
Coding
- HCPCS - General Information (HCPCS)
- DMEPOS_Jurisidiction_List [ZIP, 42KB] -- A spreadsheet containing an updated list of the HCPCS for Durable Medical Equipment Regional Carrier (DMERC) and Part B local carrier jurisdictions is updated annually to reflect codes that have been added or discontinued (deleted) each year. Changes in section 20.3, Publication 100-04 of the Claims Processing Manual are reflected in the recurring update notification.
- Alpha-Numeric HCPCS
- ICD-9-CM
- ICD-10
Program Integrity/ Medical Review
- Chapter 5 - Items and Services Having Special DME Review Considerations [PDF, 250KB] - Program Integrity Manual - Items and Services Having Special DMERC Review Considerations
- Chapter 12 - The Comprehensive Error Rate Testing Program [PDF, 87KB] - Program Integrity Manual - FI, Carrier, DMERC and RHHI Interaction and Coordination with Program Safeguard Contractors (PSCs)
Fraud & Abuse
- Beneficiary Complaint Response Program
Education
- Medicare Learning Network (MLN) General Information
- MLN Educational Web Guides
- MLN Matters Articles ( Search Tips )
- MLN Products
How to Stay Informed
- Join the mailing list (or listserv). Scroll to the right side of the page to Subscribe.
- Home Health, Hospice & Durable Medical Equipment Open Door Forum
