CMS has released revised reimbursement rates for rural and non-bid areas in non-contiguous areas, per the Interim Final Rule (IFR) it issued earlier this month.
The IFR resumes the 50/50 blended rate schedule from June 1 through Dec. 31 and will affect rural areas and non-contiguous areas (Alaska, Hawaii and U.S. territories) that are non-bid areas. However, the IFR doesn’t apply to non-bid areas in the contiguous United States. The full text of the IFR can be read here.
A fact sheet from CMS breaks down the increased fee schedule amounts, and the full rates are available at go.cms.gov/2xwR7rB.
CMS also provided a table of the state averages for the rural fee schedule amounts:
DMEPOS Item |
HCPCS |
Unadjusted Fee |
Rural Fee – Jan |
Rural Blended Fee |
Percent Increase |
Oxygen Concentrator (monthly) |
E1390 |
$182.43 |
$72.33 |
$121.46 |
68% |
CPAP (rental) |
E0601 |
$103.78 |
$43.95 |
$73.86 |
68% |
Hospital Bed (rental) |
E0260 |
$136.78 |
$65.40 |
$100.83 |
54% |
NPWT Pump (rental) |
E2402 |
$1,665,09 |
$703.16 |
$1,184.12 |
68% |
Manual Wheelchair (rental) |
K0001 |
$57.86 |
$24.50 |
$41.18 |
68% |
Power Wheelchair (rental) |
K0823 |
$585.51 |
$294.71 |
$440.11 |
49% |
Walker (purchase) |
E0143 |
$112.47 |
$50.61 |
$81.54 |
61% |
Commode Chair (purchase) |
E0163 |
$119.27 |
$56.30 |
$87.79 |
56% |
TENS (purchase) |
E0730 |
$405.26 |
$72.11 |
$238.69 |
231% |
Nebulizer (rental) |
E0570 |
$18.12 |
$6.12 |
$12.15 |
99% |
Powered Mattress (rental) |
E0277 |
$671.70 |
$205.41 |
$438.55 |
113% |
Insulin Pump (rental)1 |
E0784 |
$469.93 |
n/a |
n/a |
n/a |
Enteral Pump (rental) |
B9002 |
$123.40 |
$67.64 |
$95.57 |
41% |
Enteral Supplies (daily) |
B4035 |
$12.12 |
$5.79 |
$8.95 |
55% |
Enteral Nutrients (100 calories) |
B4150- |
$1.14 |
$0.70 |
$0.91 |
30% |
n/a: Item included in 10 or fewer CBAs and therefore has one national adjusted rate with no rural rates
Source: CMS