Phase 2 of Manual Revisions to Reflect Payment Changes for DMEPOS as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005 The Centers for Medicare & Medicaid Services (CMS) released the second installment of Chapter 36 of the Claims Processing Manual (CR 6119 and companion MLN Matters article) that provides additional information about the DMEPOS (DMEPOS) Competitive Bidding Program of interest to providers and suppliers of DMEPOS that bill Medicare Carriers, Fiscal Intermediaries, Regional Home Health Intermediaries, or Part A/B Medicare Administrative Contractors and providers who refer or order DMEPOS for Medicare beneficiaries. Of note, there is new information in this manual chapter on payment rules, change of suppliers, traveling beneficiaries, beneficiary liability, and downcoding. To view this newly released manual chapter, visit http://www.cms.hhs.gov/manuals/ on the CMS website. The companion MLN Matters article is available on the dedicated website at http://www.cms.hhs.gov/DMEPOSCompetitiveBid on the CMS website. Go to the "Provider Educational Products and Resources" tab in the left-hand column and scroll down to "Downloads" section. Click on the "DMEPOS Competitive Bidding MLN Matters" to view this new article. DMEPOS Competitive Bidding Area (CBA) Zip Code Files Two Competitive Bidding Area (CBA) zip code files will be available in the near future; one file containing mail order zip codes per CBA and one file containing non-mail order zip codes per CBA. These files will be updated on a quarterly basis, as needed, to reflect changes in zip codes included in the various CBAs. Although the boundaries of a CBA will not change during a competitive bidding contract period, zip codes in general do change from time to time (e.g., when one zip code/area is subdivided into two or more new zip codes/areas, etc.). Until the two zip code files are available, suppliers should use the "Find a CBA" tool at http://www.dmecompetitivebid.com to access lists of mail order and non-mail order zip codes per CBA. Outreach to Medicare Beneficiaries The Centers for Medicare & Medicaid Services (CMS) will begin mailing letters on the DMEPOS Competitive Bidding Program, which begins July 1, 2008, to Medicare beneficiaries living in the ten Competitive Bidding Areas (CBAs) later this month. The letter highlights the changes in the program and includes a brochure that lists the areas and supplies covered and a list of contract suppliers. A copy of the beneficiary letter and brochure is available at http://www.cms.hhs.gov/PressContacts/10_PR_DMEPOS.asp. Please Note " Tip Sheets Currently Available: - Referral Agents
- Grandfathered Suppliers
- Physicians and Other Treating Practitioners Who Are Enrolled as DMEPOS Suppliers
- Non-Contract Suppliers
- Mail Order Diabetic Contract Suppliers
Remember -- All information on the DMEPOS competitive bidding program is available at http://www.cms.hhs.gov/DMEPOSCompetitiveBid on the CMS website. | | | Downloads |
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