Quarterly Update for the Temporary Gap Period of the DMEPOS CBP - April 2019

MLN Matters Number: MM11097
Related CR Release Date: January 11, 2019
Related CR Transmittal Number: R4192CP
Related Change Request (CR) Number: 11097
Effective Date: April 1, 2019
Implementation Date: April 1, 2019

CR 11097 provides the April 2019 quarterly update for the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule. The instructions include information, when necessary, to implement fee schedule amounts for new codes and correct any fee schedule amounts for existing codes. The DME Competitive Bidding Program (CBP) files are updated on a quarterly basis in order to implement necessary changes to the HCPCS, ZIP code, and supplier files.

The Round 1 2017, Round 2 Recompete, and the National Mail Order (NMO) Recompete CBP contracts expired on December 31, 2018. Due to a delay in the announcement of the next round of the CBP, contracts are not in effect in Round 1, Round 2, or the NMO Competitive Bidding Areas (CBAs) beginning January 1, 2019, resulting in a temporary gap period in the CBP. Please make sure your billing staffs are aware of these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11097.

Last Updated Jan 14, 2019