DMEPOS COMPETITIVE BIDDING PROGRAM PHYSICIANS AND OTHER TREATING PRACTITIONERS, PHYSICAL THERAPISTS, AND OCCUPATIONAL THERAPISTS
When a new round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program becomes effective, beneficiaries with Original Medicare who live in or travel to a competitive bidding area (CBA) and are prescribed off-the-shelf (OTS) back
braces or OTS knee braces must use a competitive bidding contract supplier, unless an exception applies. This fact sheet discusses two of these exceptions for:
1. Physicians and other treating practitioners (physician assistants, nurse practitioners, and clinical nurse specialists); and
2. Physical therapists and occupational therapists
There is a similar exception for physicians and other treating practitioners that is addressed in a separate fact sheet.
From January 1, 2021, thru December 31, 2023, the CBP will only be in effect for OTS back and knee braces, so the guidance in this fact sheet only applies to these items during this time.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 23, 2020
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.