Month: December 2015

Medicare fee schedule to significantly impact DME and HME businesses starting Jan. 1, 2016

December 11, 2015 Posted on Categories DME

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

 

CPAP (rental)

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.

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