Category: Press

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

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