CMS releases fee schedule amounts for rural areas

Tuesday, November 24, 2015

WASHINGTON – CMS has released revised fee schedule amounts for 11 product categories as part of its national roll out of competitive bid pricing on Jan. 1.

CMS has based pricing in rural areas on the national weighted average plus 10%.

For oxygen concentrators, for example, that means a 22% reduction in reimbursement, on average, in rural areas from 2015 to 2016.

CMS plans to phase-in new pricing over six months. Starting Jan. 1, pricing will be based on a 50/50 blend of the current and adjusted rates. On July 1, it will be based only on the adjusted rates.

Using oxygen concentrators as an example again, providers are paid $1,086, on average, for six months under the current rates. Starting Jan. 1, they will be paid $850 in rural areas.

Last month, CMS released a preliminary list of zip codes that it considers rural.

AAHomecare late on Monday said it was analyzing the data and would provide additional information shortly.