Keeping Up with Changing Norms in Durable Medical Equipment (DME) Billing

Durable Medical Equipment (DME) essentially refers to a special class of therapeutic equipment prescribed by licensed physicians to patients with specific medical conditions or illnesses, to help them attain a better living standard and aid in livelihood. Some typical items that fall in this category are nebulizers, ventilators, CPAP machines, hospital beds, walkers and so on. It is important to note that DME items are built to withstand extended periods of use and are primarily intended for use in home settings.

As the DME landscape continues to evolve, it is vital for providers and healthcare professionals to stay updated on the latest developments in DME billing. An example may be given in the Competitive Bidding Program (CBP), an important update in DMEPOS billing regulations.

All about the DMEPOS Competitive Bidding Program (CBP)

Since January 01, the CBP is under a temporary gap period. The DMEPOS CBP All Medicare Round 2021 contracts for OTS (Off-the-Shelf) back braces and OTS knee braces expired on December 31, 2023. This interruption is important as it might impact the availability of crucial medical equipment for patients. CMS will again begin bidding for the next round of the DMEPOS CBP after completing the public notice and comment rulemaking process and implementing necessary changes. These changes aim to establish sustainable prices, save money for Medicare beneficiaries and taxpayers, limit fraud, waste and abuse, and ensure access to quality items and services.

The Centers for Medicare & Medicaid Services (CMS) is proactively addressing the situation. This approach aims to further enhance the DMEPOS CBP and ensure a steady supply of durable medical equipment for patients. For more information on the temporary gap period, refer to the Temporary Gap Period fact sheet provided by CMS. For seamless DME billing operations, it is further recommended to keep an eye on updates from the CMS.gov website and the Competitive Bidding Implementation Contractor (CBIC) websites as well.

Today even a single update in DMEPOS billing is essential for providers, suppliers, and healthcare professionals to ensure compliance and continued support for patients in need of such equipment. Keeping abreast of these changes is crucial in delivering a smooth and uninterrupted DME billing transaction.

Sunknowledge Caters to All Your DME Billing Needs

Offering you seamless support in pre- and post-billing operations, Sunknowledge is known for its consistently high productivity metrics and its ability to drastically improve ROI. Being fully updated on the recent industry mandates and all the latest DME regulations, Sunknowledge ensures fewer errors and more claim approvals. With dedicated follow-up programs with Doctor’s offices, and maintaining a constant lookout for all changes in DME billing norms and regulations, Sunknowledge is your trusted partner to end all your DME billing challenges. Get in touch with a Sunknowledge professional now and improve your ROI in no time.