What’s the state of the HME industry?

Friday, December 4, 2015

YARMOUTH, Maine – Medicare allowed charges for DME bounced back a bit in 2014 compared to 2013, according to the 2015 State of the Industry Report.

Allowed charges for DME-related BETOS “buckets”* were $5.8 billion in 2014 compared to $5.3 billion in 2013.

Still, that’s a far cry from the $8.1 billion in allowed charges in 2012, $7.8 billion in 2011 and $8.5 billion in 2010, when Medicare first launched competitive bidding.

Allowed charges for the majority of individual DME saw decreases in 2014 compared to 2013. Allowed charges for oxygen concentrators, for example, were $1.19 billion, a decrease of about 15.5%. Charges for CPAP devices were $181.69 million, a decrease of about 20.5%.

Some products did see increases in allowed charges in 2014. Allowed charges for vents (E0463), for example, were $63.4 million, an increase of about 12%.

The number of providers supplying the most popular DME products continues to drop. For oxygen concentrators, for example, there were 6,862 providers in 2014 vs. 7,491 in 2013. For CPAP devices, there were 6,628 vs. 7,239.

The State of the Industry Report also includes a list of 100 top Medicare providers (Lincare comes out on top again in 2014), and a breakdown of the number of providers by how much they billed Medicare (there were decreases across the board in 2014). 

*BETOS is a coding system developed to analyze the growth in Medicare expenditures. It covers all HCPCS codes; assigns a HCPCS code to only one BETOS bucket; consists of readily understood clinical categories that permit objective assignment; is stable over time; and is relatively immune to minor changes in technology or practice patterns.