BREAKING NEWS! CMS announces Round 2021 payment amounts for back, knee braces

WASHINGTON - CMS has announced Round 2021 single payment amounts for off-the-shelf back braces and knee braces—and only those product categories.

The agency says it is not awarding contracts for any of the 13 product categories that were previously competed because the payment amounts did not achieve expected savings.

Contract offers for back and knee braces have been made in 127 CBAs, a move that CMS expects to save $600 million for the Medicare program and beneficiaries over the three-year contract period.

CMS is not making offers for back and knee braces in certain CBAs where savings would not be achieved. Payment in those areas will be based on adjusted fee schedule amounts.

The announcement comes after pressure from Congress and the HME industry not to start the next round of the program on Jan. 1 as scheduled due to capacity, supply chain and other issues created by the COVID-19 pandemic.

CMS had initially paused its next round of the program in 2018 so it could make changes, including incorporating lead-item pricing and bid surety bonds.

Earlier this year, in the beginning of the pandemic, CMS also decided to drop non-invasive ventilators from Round 2021.

Round 2021 contracts will go into effect on Jan. 1, 2021. CMS plans to announce the contract suppliers later this fall.

Learn about contract supplier obligations and more on the Competitive Bidding Implementation Contractor