US · guidance
CMS Pub. 100-16, ch. 4, § 10.12.5
DMEPOS Competitive Bid Program
On January 1, 2011, the original Medicare payment amount for DMEPOS competitive
bid items furnished in Competitive Bidding Areas (CBAs) was reduced below the fee
schedule payment. The program only affects certain geographic areas and certain
categories of DMEPOS; exceptions may apply. For the latest guidance refer to
information at http://www.cms.gov/DMEPOSCompetitiveBid/. The program affects MA
payments in those situations when an MA plan is only required to pay at least the original
Medicare rate, for example, when reimbursing suppliers that are not under contract with
the MA plan. MAOs must disclose information on the new program to their plan
enrollees. MAOs should inform enrollees how the DMEPOS competitive bidding
program will affect them and what they should do if they need to change suppliers, for
example, in cases where an enrollee’s current supplier is not one of the “Medicare
contract suppliers” under the DMEPOS competitive bidding program and they cannot be
grandfathered under the DMEPOS competitive bidding program.
History
(Rev. 121, Issued: 04-22-16, Effective: 04-22-16, Implementation: 04-22-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
fc38ff99150482f48689e07cbb9367a0582a9a672c4238924608f15fde73e34b
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