CMS Releases Rural Relief Adjustments

Agency adjusts reimbursement as mandated by the recently released IFR.

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-
B4154

$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

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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