2019 Medicare Fee Schedule Adjusted for Inflation

Increases range between 2.3%-2.5%, marking highest inflation-related upticks since CMS first implemented competitive bidding.

CMS has released the 2019 Medicare fee schedule information, and several categories saw between a 2.3 percent and 2.5 percent increase after adjustments per the Consumer Price Index for all Urban Consumers (CPI-U).

While a modest gain, the increases are the highest since CMS started implementing competitive bidding, with previous increases averaging 1.3 percent and the highest increase during that time topping out at 2.1 percent, according to the American Association for Homecare.

Some detail on the adjustments:

  • Former competitive bidding areas saw an SPA increase of  2.5 percent.
  • National mail-order diabetic supplies got an SPA boost of  2.5 percent.
  • Non-mail-order diabetic supplies remain at the current rate.
  • Items not included in competitive bidding are at 2018 rates plus 2.3 percent.
  • SPAs for rural, non-contiguous areas are at 50 percent of the unadjusted fee schedule and 50 percent of the new adjusted fee schedule.

A statement from AAHomecare noted it has contacted CMS for clarification on whether non-rural areas outside of former CBAs will get the indirect benefit of the CPI increase in former CBAs.

AAHomecare President and CEO Tom Ryan noted that the increases are far from the real reimbursement reforms providers require.

“While adjustments to keep pace with inflation are certainly welcomed by home medical equipment suppliers, they do nothing to offset the deep reimbursement cuts produced by the bidding program over the last seven years,” Ryan said. “Even with the gains for rural suppliers and reforms for future rounds of the bidding program achieved in 2018, this fee schedule update reminds us that we are a long way from a sustainable Medicare reimbursement environment.”

CMS’s fee schedule update is available as a PDF at bit.ly/2RYZMZX.

About the Author

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

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