Introduction The Centers for Medicare & Medicaid Services (CMS) has issued an update to the Medicare Claims Processing Manual regarding the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule. This update reflects changes for the April 2024 quarter and includes important revisions for claims with dates of service starting January 1, 2024.

Key Updates

1. Effective Dates and Implementation
   • The changes in this update are effective from January 1, 2024.
   • Implementation for these changes is set for April 15, 2024.
2. Business Requirement (BR) 13574.9
   • This new requirement is added to ensure accurate processing and reimbursement for DMEPOS items.
   • It emphasizes the need for adherence to the updated fee schedule and ensures all claims are processed according to the latest guidelines.
3. Fee Schedule Adjustments
   • The fee schedule for DMEPOS items is updated quarterly to reflect current pricing and regulatory adjustments.
   • These changes are essential for maintaining fair and accurate reimbursement rates for suppliers.

Compliance and Education

• Suppliers and providers are encouraged to review these updates and ensure their billing practices align with the new requirements.
• CMS will provide educational resources to help stakeholders understand and implement the changes effectively.

Conclusion This quarterly update is part of CMS’s ongoing efforts to ensure the DMEPOS fee schedule is current and reflective of the latest regulatory standards. By staying informed and compliant, providers can ensure smooth processing and appropriate reimbursement for DMEPOS items.