On March 1, 2021, the Centers for Medicare & Medicaid Services (CMS) sent out a revised DMEPOS Fee Schedule. You can access the schedule here.
DMEPOS Fee Schedule Errors
CMS identified errors in the original schedule published on December 11, 2020, and adjusted 919 HCPCS codes.
In AAHomecaree’s analysis, generally, the errors found non-rural areas would receive 0.9% more rural areas would receive 0.5% more than the original published 2021 fee schedule. However, some fee schedule adjustments range is between -30% to +57% of the original 2021 fee schedule. KE modifier codes have the most significant changes.
What if you already submitted a claim and it was paid?
If suppliers submitted claims before January 26, 2021, and the claims were paid, check the updated fee schedule to see if the paid amount is incorrect. Then submit a request to the DME MAC to process the paid claims (that information is forthcoming).