Durable Medical Equipment (DME) Center

• Medicare DMEPOS Competitive Bidding contract suppliers for Round 2 and the national mail-order program for diabetic testing supplies have been announced.  View Press Release http://www.cms.gov/apps/media/press_releases.asp and Fact Sheet http://www.cms.gov/apps/media/fact_sheets.asp.

• Revised Fact Sheet for Referral Agents - Where are the Round 2 areas?  What if a beneficiary travels? What do you need to know before prescribing a DMEPOS item or referring the beneficiary to a DMEPOS supplier? Want more information on the national mail-order program for diabetic testing supplies?

  For answers to these questions and more, see the revised “Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program: Referral Agents” Fact Sheet (ICN 900927), which is now available in downloadable format. 

• Information for people who refer Medicare beneficiaries for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). The DMEPOS Competitive Bidding Program is how some Medicare patients get covered supplies. Be sure to give your Medicare patients the correct information.
  
  

• Temporary Delay in Implementing Ordering and Referring Denial Edits 
  Due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed. These edits would have checked the following claims for an approved or validly opted-out physician or non-physician who is an eligible specialty type with a valid individual National Provider Identifier (NPI). If either of these were missing or incorrect, claims would deny.  

  • Medicare Part B claims from laboratories, imaging centers and Durable Medical Equipment, Orthotics, and Supplies (DMEPOS) that have an ordering or referring physician/non-physician provider; and  
  • Part A Home Health Agency (HHA) claims that require an attending physician provider. 

  CMS will advise you of the new implementation date in the near future. In the interim, informational messages will continue to be sent for those claims that would have been denied had the edits been in place.  For more information, see the revised article  SE1305 – Full Implementation of Edits on the Ordering/Referring Providers in Medicare Part B, DME, and Part A Home Health Agency (HHA) Claims.

• Medicare DMEPOS Competitive Bidding single payment amounts for Round 2 and the national mail-order program for diabetic testing supplies have been announced.  View Press Release  and Fact Sheet
• 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)
• Blood Clotting Factor Furnishing Fee

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