DME MACs Publish Post-PHE Directions for DME Suppliers
- By Laurie Watanabe
- May 02, 2023
With the federal COVID-19 public health emergency (PHE) set to expire May 11, the DME MACs have published new post-PHE directions for suppliers of durable medical equipment (DME).
An American Association for Homecare (AAHomecare) bulletin to stakeholders on April 28 said, “The new instructions state that for claims impacted by the COVID-19 PHE, the CR modifier and COVID-19 narrative can be continued to be used for ongoing rental and supplies/accessories after the end of the PHE on May 11th. This rescinds the announcement made in the March MLN Connects which directed suppliers to stop the use of the CR modifier after the end of the COVID-19 PHE.”
The joint DME MAC Publication posted April 28 said, “To address concerns for continued claims payment of DMEPOS items provided during the PHE and to identify claims for supplies and accessories associated with DMEPOS items initially dispensed, rendered or otherwise impacted by the PHE, the DME MACs are instructing suppliers to continue the use of the CR modifier (catastrophe/disaster related) and COVID-19 narrative. The CR Modifier and COVID-19 narrative can continue to be used for any DMEPOS item (ongoing rentals) and related supplies/accessories where the base item was initially dispensed, rendered or otherwise impacted by the PHE (dates of service on March 1, 2020, through May 11, 2023) and specifically excluded from enforcement of the clinical indications of coverage referenced in Interim Final Rules CMS-1744-IFC and CMS-5531-IFC. The use of the CR modifier and COVID-19 narrative is intended to allow the DME MACs to implement new system editing for PHE-dispensed DMEPOS items and provide the ability to identify these claims for future review, if indicated.”
The DME whose National Coverage Determinations and Local Coverage Determinations were impacted by the PHE interim rules include home oxygen; infusion pumps; CPAP and PAP systems; oxygen and oxygen equipment; respiratory-assist devices; nebulizers; suction pumps; and glucose monitors, among others.
Laurie Watanabe is the editor of Mobility Management. She can be reached at firstname.lastname@example.org.