CMS to revise revised fee schedule

Wednesday, December 2, 2015

BALTIMORE – CMS will revise its recently released 2016 DMEPOS fee schedule after finding errors, the agency has announced.

The agency released the revised fee schedule Nov. 23. It includes adjusted payment amounts for 11 product categories as part of its national roll out of competitive bid pricing on Jan. 1.

“CMS identified errors in the fee schedule amounts for some items and will therefore be releasing revised fee schedule files within the next week,” the agency stated on Dec. 1. “A list of the items affected by the revisions will be included in a separate public use file along with the revised 2016 fee schedule public use files.”

The fee schedule for non-bid areas was developed in two ways: the average pricing in the competitive bidding areas in the region for regional areas; and the national weighted average plus 10% for rural areas.

Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.D., have introduced a bill that seeks to soften the blow of the rollout of the adjusted payment amounts. S. 2312 would increase rural single payment amounts by 30%, and increase regional SPAs by 20% in all other non-bid areas.