Sneak peek at 2014 data


If it’s summer in Maine, it means I’m in the throes of requesting, collecting and analyzing Medicare data sets for two upcoming projects: the annual update of our HME Databank (it happens Oct. 1!) and the publication of the State of the Industry Report (it will be an insert in the December issue).

Both will feature 2014 data.

To put 2014 in perspective, let’s consider that pricing for the Round 1 re-compete went into effect Jan. 1, 2014, and six months before that, pricing for the Round 2 re-compete went into effect July 1, 2013.

I pulled Medicare’s allowed charges for some of the more popular DMEPOS codes, like:

E1390: $1,186,187,433 (vs. $1,403,398,730 in 2013)

E1392: $30,644,855 (vs. $29,359,144 in 2013)

No drastic changes there. How about:

E0601: $181,689,399 (vs. $228,523,480 in 2013)

That’s a change.

How about:

A4253: $317,741,495 (vs. $753,293,520 in 2013)

Yikes. The Round 2 re-compete that went into effect July 1 included a national mail-order program for diabetes supplies that reduced reimbursement by 72%.

For you mobility folks, how about:

K0823: $55,990,584 (vs. $133,239,857 in 2013).

Yikes again. As you know, in addition to competitive bidding, this product has been subject to prior authorization approval in a number of states.

Well, there’s more where this came from.

Stay tuned.