CMS Announces 5% DMEPOS Fee Schedule Increase

The rates for the calendar year 2022 are higher than past years, reflecting increases in the consumer price index.

CMS has published DMEPOS fee schedule adjustments for the calendar year 2022, and while the adjustments differ depending on whether the items serviced are competitive bidding program items or in former competitive bidding areas (CBAs), they are generally higher than in the past.

The basic rate increases:

  • Competitive bidding program items in former CBAs have increased 5 percent.
  • Competitive bidding program items in non-CBAs have increased 5.4 percent.
  • Non-competitive bidding program items are up 5.1 percent.

Typically, the increases for DME, based on the Bureau of Labor Statistics’ Consumer Price Index for Urban Consumers (CPI-U), come in between 1 percent and 3 percent. Last year, the inflation adjustment was less than 1 percent. As widely reported, prices have increased this year.

Moreover, the gains don’t reflect the considerable operational cost increases HME providers have seen during the COVID-19 pandemic.

“While suppliers will welcome these increases, the DME community still needs additional rate adjustments to account for the widespread product price hikes, shipping surcharges, and new operational requirements that have increased costs for our industry,” said Tom Ryan, president and CEO of the American Association for Homecare. “Suppliers need Medicare reimbursement rates that truly reflect the market realities they face.

“What’s more, these increases will essentially be canceled out unless Congress takes action to waive looming 4 percent paygo-driven cuts for FY 2022 and extend the pause on the 2 percent Medicare sequester until the end of the ongoing public health emergency,” he continued. “Cutting reimbursements during a pandemic doesn’t make sense and we need to make sure Capitol Hill gets that message.”

In addition, CMS affirmed the continued adjustments for rural and other non-bid area relief included in the CARES Act.

“Since the public health emergency has not ceased, the update for the 2022 DMEPOS and PEN fee schedule files continue to include the rural and non-contiguous non-CBA 50/50 blended fees and the non-rural contiguous non-CBA 75/25 blended fees required by section 3712 of the CARES Act.”

CMS will publish the official Calendar Year 2022 fee schedule soon. See the Calendar Year 2022 Update for DMEPOS Fee Schedule (CMS’ Claims Processing Update Change Request 12521) for more information.

 

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