The Centers for Medicare & Medicaid Services (CMS) has updated its fee schedule for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) paid for by Medicare.
The new fee schedule is effective Jan. 1, 2026.
CMS announced the Consumer Price Index Urban (CPI-U) percentage increase as 2.7%. But as the American Association for Homecare (AAHomecare) said in a Dec. 22 bulletin, “The inflation adjustment will differ depending on whether the item has been included in the competitive bidding program and whether the patient’s ZIP code is in a former competitive bidding area.”
For competitive bidding program items in former competitive bidding areas, AAHomecare said the projected percentage change is 2.8%. The CPI-U for competitive bidding program items in non-competitive bidding areas is 2.7%, AAHomecare said, while noting the number is “not directly stated in the change request.” The bulletin added that 2.0% is the CPI-U minus productivity adjustment for non-competitive bidding items.
“For items such as CPAP devices, oxygen, standard and power wheelchairs, and NPWT [negative pressure wound therapy] where the payment is based on competitive bidding program payment rates, the 2.8% increase should be directly applied to the current 2025 fee schedule,” AAHomecare said. “For items that have never been part of the competitive bidding program, such as urological and ostomy supplies, the 2.0% inflation adjustment should be directly applied to the current 2025 fee schedule, regardless of location in the country.”
CMS said lymphedema compression treatment items would get an update factor of 2.7% “applied to the national payment amounts for lymphedema compression treatment items” for calendar year 2026.
AAHomecare said it would provide “further analysis of the new rates” after the holidays.
