Replacement Wheelchair Equipment When Manufacturers Exit the Business
Hospice Payment Rates and Cap Updates
The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 13707, effective October 1, 2024, which introduces critical updates to hospice payment rates, the hospice wage index, and the hospice cap amount for the fiscal year (FY) 2025. These changes are essential for hospice providers to understand and implement as they impact […]
Separate Payment for Disposable Negative Pressure Wound Therapy Devices
Starting January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will implement a significant change under Change Request (CR) 13244, which introduces separate payments for Disposable Negative Pressure Wound Therapy (dNPWT) devices under the Home Health Prospective Payment System (HH PPS). This update marks an important shift in how these devices are billed […]
Refining Home Health Payment Reductions for Quality Data Submission
The Centers for Medicare & Medicaid Services (CMS) has issued an important update through Change Request (CR) 13241, which becomes effective on January 1, 2023. This update is designed to enhance the accuracy and efficiency of payment processes for Home Health Agencies (HHAs) that do not submit the required quality data. The update fully replaces […]
CMS Update: Key Changes in Home Health Claims Processing Effective January 1, 2024
The Centers for Medicare & Medicaid Services (CMS) has issued an important update, Change Request (CR) 13225, set to take effect on January 1, 2024. This update aims to enhance the accuracy and efficiency of processing home health (HH) claims. Here’s what you need to know: Removal of the Edit Bypass for Condition Code DR […]
Corrections to Home Health Processing – Claims with Condition DR or Claims Receiving Admission Source Edits
The Centers for Medicare & Medicaid Services (CMS) has issued a new Change Request (CR) 13225, effective January 1, 2024, aimed at refining the processing of home health (HH) claims. This update focuses on improving the accuracy and efficiency of claims reporting condition code DR and handling admission source edits. Key Changes: Removal of Edit […]
Understanding the Competitive Bidding Program for Durable Medical Equipment (DME)
Understanding the Competitive Bidding Program for Durable Medical Equipment (DME) The Competitive Bidding Program (CBP) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) is designed to improve the efficiency of Medicare payments for DME and ensure that beneficiaries have access to quality medical equipment at lower costs. The program encourages suppliers to submit […]
Reimbursement Changes
Reimbursement Changes Medicare Reimbursement Rate Adjustments: Background: Medicare periodically adjusts reimbursement rates for DME based on market data and competitive bidding outcomes. Recent Changes: Rates have been adjusted to reflect the savings achieved through competitive bidding, with reductions in payment rates for many items. Impact: Lower reimbursement rates can challenge the profitability of DME […]
Product Trends in Durable Medical Equipment (DME)
Product Trends in Durable Medical Equipment (DME) The demand for durable medical equipment (DME) is being driven by several factors, including the rise in sleep disorders, respiratory diseases, and the growing preference for home-based care. Key products experiencing high demand include CPAP supplies, oxygen tanks, personal mobility devices, and home medical furniture. Let’s delve […]
Mobility Devices Industry: Profits and Losses, Low-Cost Manufacturing, and Insurance Payments
he durable medical equipment (DME) industry is witnessing significant growth due to an aging population, rising chronic diseases, and technological advancements. Companies are expanding their geographic presence and leveraging strategic partnerships to meet diverse healthcare needs. This growth is further driven by the increasing demand for home healthcare solutions. Key players like Invacare, Sunrise Medical, and Medline Industries are continuously innovating to maintain profitability and market reach. Understanding financial dynamics, sourcing strategies, and insurance billing processes are crucial for navigating this evolving industry.
