In November, the Centers for Medicare & Medicaid Services (CMS) released the 2016 Fee Rates and Policies. There are significant rate schedule amount decreases for Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS).
Unfortunately, the updated fee schedule lowers reimbursement rates to DME and HME retailers a broad range of items, including oxygen concentrators, CPAPs, and hospital beds. This will impact the retailers profitability significantly.
Some specifics include:
Oxygen concentrator (monthly)
2015 fee: $180.92
2016 blended urban/rural fees: $137.04/$141.74
This represents a -24% and -22% reduction, respectively
2015 fee: $102.35
2016 blended urban/rural fees: $74.61/$76.91
This represents a -27% and -25% reduction, respectively
Hospital Bed (rental)
2015 fee: $134.38
2016 blended urban/rural fees: $102.53/$106.09
This represents a -24% and -21% reduction, respectively
DME/HME retailers should take some time to review the updated fee schedule and ensure their billing software is updated. Additionally, take the lowered rates into account when budgeting and planning for 2016.