Durable Medical Equipment (DME) Center
Spotlights
- Registration is open for the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program. Visit the Competitive Bidding Implementation Contractor website to register.
- The CMS has announced the timeline for bidding and initiated a comprehensive supplier education program leading up to the bidding period for the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program. Suppliers interested in bidding should visit the Competitive Bidding Implementation Contractor website.
The Centers for Medicare & Medicaid Services hosted a public meeting on July 23, 2012 regarding the inherent reasonableness of Medicare fee schedule amounts for non-mail order (retail) diabetic testing supplies. The audio recording and transcript of this meeting is now available at the DMEPOS Fee Schedule web page. The deadline for submission of written comments has been extended to 5 p.m. e.d.t. Friday, August 10th.
- 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
Medicare Learning Network (MLN) Spotlights
Go to the 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 - Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) [PDF, 437KB] (Medicare Claims Processing Manual)
- 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
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