US · guidance
CMS Pub. 100-04, ch. 36, § 40.1
Single Payment Amount
The single payment amount for each competitively bid item in each CBA is based on the bids
submitted and accepted for that item. Only bids from qualified suppliers (those that met all
quality and financial standards and eligibility and accreditation requirements) are considered in
setting the single payment amount. The single payment amount for an item furnished under the
competitive bidding program is equal to the median of the bids submitted for that item by
qualified suppliers whose composite bids for the product category are equal to or below the
pivotal bid for that product category. The single amount is determined by CMS and remains in
effect for the duration of a contract period and is not adjusted for inflation. A listing of the single
payment amounts will be posted at the CBIC Web site at http://www.dmecompetitivebid.com.
See section 100.5 of chapter 23 of the Claims Processing Manual for instructions regarding
adjustments to the single payment amounts as a result of changes in the HCPCS.
History
(Rev. 1532, Issued: 06-11-08, Effective: 07-01-08, Implementation: 07-07-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
ee3acf7153e612eee91773b6e234769d54f4ab77160e4fc146356efbb0089f70
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