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CMS announces gap period in bid program

CMS announces gap period in bid program

WASHINGTON – CMS has announced there will be a temporary gap period in the DMEPOS competitive bidding program, when the current Round 2021 contracts for off-the-shelf back and knee braces expire on Dec. 31, 2023. 

During the gap period, which starts on Jan. 1, 2024, suppliers may furnish items and services to patients under the following payment rules: 

  • Adjusted fees in former competitive bidding areas (CBAs) are based on 100% of the single payment amount for the CBA increased by the projected percentage change in the Consumer Price Index for All Urban Consumers (CPI-U) from January 2023 - January 2024 
  • Adjusted fees in non-CBAs are based on fully adjusted rates per the applicable methodology under 42 CFR 414.210(g) 

CMS says it will start bidding for the next round of the bid program after it: 

  • Completes the formal public notice and comment rulemaking process 
  • Implements necessary DMEPOS CBP changes to:  
    • Establishes sustainable prices 
    • Saves money for Medicare patients and taxpayers
    • Help limit fraud, waste, and abuse in the Medicare Program 
    • Ensures patient access to quality items and services 

In 2020, CMS announced Round 2021 single payment amounts for off-the-shelf back braces and knee braces. It did not announce payment amounts for 13 other product categories that were previously part of the program due to insignificant savings.


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