In response to a legislative mandate to set durable medical equipment (DME) prices pursuant to a competitive bidding process, the Centers for Medicare & Medicaid Services (CMS) has released DME payment amounts for nine communities where the new price structure will go into effect Jan. 1, 2011. These communities are: Charlotte-Gastonia-Concord in North and South Carolina; Cincinnati-Middletown in Ohio, Kentucky and Indiana; Cleveland-Elyria-Mentor in Ohio; Dallas-Fort Worth-Arlington in Texas; Kansas City in Missouri and Kansas; Miami-Fort Lauderdale-Pompano Beach in Florida; Orlando, Fla.; Pittsburgh, Pa.; and Riverside-San Bernardino-Ontario in California.
Under this new payment system, a single price is set for specific DME items and supplies for the applicable areas. As reported to the AASM, the payment amounts would be applied on a monthly basis for items currently reimbursed on a monthly rental rate. For items where the DME contractor has set a timetable that sets out “the usual maximum amount of accessories expected to be medically necessary,” Medicare payment amounts would be allowed based on frequency set out in that table.
CMS is in the process of scheduling educational forums in the coming months in the affected communities. Get more details about the payment amounts in the currently identified competitive bid areas.