Durable Medical Equipment, Prosthetics/Orthotics, and Supplies Fee Schedule

DMEPOS Transmittals

The list below shows the transmittals that are directed to the DMEPOS provider community, but the list may not include all instructions for which DMEPOS providers are responsible. For a list of all instructions, view the Transmittals web page under Regulations and Guidance.

CR # Release Date Subject Article #
5417 12/08/2006 Fee Schedule Update for 2007 for Durable Medical Equipment, Prosthetics, Orthotics and Supplies MM5417
5419 12/22/2006 Provider Migration N/A
5367 12/22/2006 DMERC Claim Modifiers for Upgrades N/A
6714 01/15/2010 Durable Medical Equipment and the National Supplier Clearinghouse Procedures for Third Party Notification of Deceased Durable Medical Equipment, Prosthetics, Orthotics and Supplies Supplier Associates N/A
6421 12/16/2010 Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplier (DMEPOS) Suppliers Claims Process by Durable Medical Equipment Medicare Administrative Contractors (DMEMACs) N/A
6695 02/05/2010 Common Working file Edit to Reject Claims for Durable Medical Equipment Provided to Medicare Beneficiaries During Non-Covered Stays in a Skilled Nursing Facility N/A
6359 02/05/2010 Reporting the Beneficiary's Residence State Code and ZIP Code for Durable Medical Equipment, Prosthetics, Orthotics and Supplies Claims MM6359
6792 02/05/2010 Maintenance and Servicing Payments for Certain Oxygen Equipment on or After July 1, 2010 MM6792
6762 02/05/2010 Instructions for Reprocessing Claims and Recouping Overpayments for Claims for Implanted DME and Implanted Prosthetics Submitted Under the Guidelines Established in Change Request 5917 MM6762
6421 02/26/2010 Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics and Supplier Claims Process by Durable Medical Equipment Medicare Administrative Contractors MM6421
6360 03/26/2010 Update VIPS Medicare System to Deactivate Billing Numbers for Non-Frequent Billing Durable Medical Equipment, Prosthetics, Orthotics and Supplies Suppliers N/A
6939 04/24/2010 Payment of Oxygen Contents to Suppliers After the 36th Month Rental Cap under the Medicare Durable Equipment Prosthetics, Orthotics and Supplies Competitive Bidding Program MM6939
6877 04/28/2010 Sending DMEPOS Medicare Summary Notices on a Monthly Schedule to all beneficiaries in Miami-Dade, Broward and Palm Beach County Zip Codes in Florida N/A
6795 04/29/2010 Additional Medicare Secondary Payer Claims Processing Instructions for the Common Working File, Medicare Part B, and Durable Medical Equipment Shared Systems Regarding Medicare Secondary Payer Claims that Contain a Claim Adjustment Reason Code 19, 20 and 21 N/A
6934 04/29/2010 Durable Medical Equipment National Competitive Bidding Implementation - Phase 10G: Paying for Oxygen Equipment when Grandfathered N/A
6591 03/16/2010 5010-D0 Project Receipt, Control and Balancing Initial Phase for Durable Medical Equipment N/A
6918 04/30/2010 Durable Medical Equipment National Competitive Bidding Implementation - Phase 10C: Exception for Medicare Beneficiaries Previously Enrolled in a Medicare Advantage Plan MM6918
6838 04/30/2010 Payment for Replacement of Oxygen Equipment in Bankruptcy Situations N/A
6945 05/07/2010 July Quarterly Update for 2010 Durable Medical Equipment, Prosthetics, Orthotics, and Suppliers (DMEPOS) Fee Schedule MM6945
6566 05/21/2010 Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies MM6566
7300 01/07/2011 Emergency Update to CY 2011 Medicare Physician Fee Schedule (MPFS) Database N/A
7235 01/14/2011 Home Oxygen Use to Treat Cluster Headache (CH) MM7235
7257 01/14/2011 2011 Durable Medical Equipment Prosthetics, Orthotics, and Supply Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List MM7257
7116 01/14/2011 Elimination of Lump Sum Purchase Payment for Standard Power Wheelchairs Furnished on or after January 1, 2011 due to the Affordable Care Act (ACA) MM7116
5641 06/08/2007 July Quarterly Update for 2007 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule MM5641
7300 12/29/2010 Emergency Update to the CY 2011 Medicare Physician Fee Schedule (MPFS) Database MM7300
6159 06/20/2008 National Competitive Bidding (NCB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), Medicare Summary Notice (MSN), and Remittance Advice (RA) Messages N/A
6112 06/13/2008 Payment for Complex Rehabilitative Power Mobility Device Services that Span the Implementation Date of DMEPOS Competitive Bidding Programs in Competitive Bidding Areas MM6112
6069 06/20/2008 National Competitive Bidding (NCB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) - Phase VIIB of Implementation N/A
6101 06/13/2008 July 2008 Quarterly Update for the DMEPOS Competitive Bidding Program MM6101
5838 01/11/2008 Annual Type of Service (TOS) Update N/A
5285 03/21/2007 Provider/Supplier Enrollment Approval Letters N/A
6007 06/26/2008 Manual Revisions to Reflect Special Billing Instructions for DMEPOS Items as a Result of the DMEPOS Competitive Bidding Program MM6007
6119 06/11/2008 Phase 2 of Manual Revisions to Reflect Payment Changes for DMEPOS Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005 MM6119
7248 01/24/2011 CY 2011 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule N/A
7261 01/28/2011 Additional Healthcare Common Procedure Coding System (HCPCS) Codes Payable Under the Replacement Parts, Accessories, and Supplies Pricing Logic Established By Change Requests (CRs) 5917 and 6573 MM7261
7231 01/28/2011 FISS System Changes for the Elimination of Lump Sum Purchase Payment for Standard Power Wheelchairs Furnished on or After January 1, 2011, Due to the Affordable Care Act N/A
5597 06/29/2007 IOM Pub 100-09, Chapters 3, Provider Inquiries and Chapter 6 - Provider Customer Service Program Updates MM5597
5597 07/13/2007 IOM Pub. 100-09, Chapters 3- Provider Inquiries and Chapter6- Provider Customer Service Program Updates N/A
7228 02/04/2011 Auto Denial of Claim Line(s) Items Submitted With a GZ Modifier MM7228
7228 02/04/2011 Auto Denial of Claim Line(s) Items Submitted With a GZ Modifier MM7228
5978 05/09/2008 Phase 1 of Manual Revisions to Reflect Payment Changes for DMEPOS Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act (DRA) of 2005 MM5978
5771 11/02/2007 Reporting an NPI and the 'EY' Modifier on Claims for DMEPOS Items Dispensed Without a Physician's Order to Obtain a Medicare Denial for Coordination of Benefits (COB) MM5771
5803 12/07/2007 Fee Schedule Update for 2008 for Durable Medical Equipment, Prosthetics, Orthotics and Supplies MM5803
5803 12/13/2007 Fee Schedule Update for 2008 for Durable Medical Equipment, Prosthetics, Orthotics and Supplies MM5803
5929 04/18/2008 Establish Pre-Payment Auto-denial Edit in Applicable States for DMEPOS Suppliers of Oxygen and Oxygen Equipment (DME MACs Only). MM5929
5914 04/18/2008 Removal of VIPS Medicare System (VMS) and Common Working File (CWF) Edits That Deny Claims for Parenteral or Enteral Services and/or Supplies if a Provider Has Not Recertified the Beneficiary's Need for Parenteral or Enteral Services and/or Supplies N/A
5979 04/18/2008 Assignment of Providers to MACs MM5979
5953 04/25/2008 Local Coverage Determinations (LCDs) Responsibility Transition From Durable Medical Equipment (DME) Program Safeguard Contractor (PSC) to DME Medicare Administrative Contractors (MAC) N/A
6055 05/16/2008 National Competitive Bidding (NCB) for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Phase VII Correction of Common Working File (CWF) Category for Portable Oxygen N/A
6022 05/23/2008 July Quarterly Update for 2008 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule MM6022
4876 04/18/2007 New DMEPOS Certificates of Medical Necessity (CMNs) and DME Information Forms (DIFS) for Claims Processing N/A
5537 03/09/2007 April Quarterly Update for 2007 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule MM5537
6159 06/20/2008 National Competitive Bidding (NCB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), Medicare Summary Notice (MSN), and Remittance Advice (RA) Messages N/A
7333 03/04/2011 Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) MM7333
6934 06/10/2010 Durable Medical Equipment National Competitive Bidding Implementation Phase 10G: Paying for Oxygen Equipment when Grandfathered MM6934
6990 06/08/2010 Clarification of the Date of Service for Maintenance and Servicing Payments for Certain Oxygen Equipment After July 1, 2010 MM6990
6970 06/11/2010 Reprocessing of Claims for Certain Replacement Parts, Accessories, or Supplies for Prosthetic Implants and Surgically Implanted Durable Medical Equipment (DME) with Dates of Service of October 27th, 2008 through December 31, 2009 MM6970
6918 06/18/2010 Durable Medical Equipment National Competitive Bidding Implementation -- Phase 10C: Exception for Medicare Beneficiaries Previously Enrolled in a Medicare Advantage Plan MM6918
7021 06/25/2010 Guidance on Implementing Section 3109 (a) of the Patient Protection and Affordable Care Act (PPACA) MM7021
6945 07/01/2010 July Quarterly Update for 2010 Durable Medical Equipment, Prosthetics, Orthotics, and Suppliers (DMEPOS) Fee Schedule MM6945
7070 07/23/2010 October Quarterly Update for 2010 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule MM7070
6714 07/27/2010 Durable Medical Equipment (DME MAC) and the National Supplier Clearinghouse (NSC MAC) Procedures for Third Party Notification of Deceased Durable Medical Equipment, Prosthetic, Orthotic and Supplies (DMEPOS) Supplier Associates N/A
7014 07/30/2010 Home Health Agencies (HHAs)Providing Durable Medical Equipment(DME)in Competitive Bidding Areas MM7014
6891 08/20/2010 New Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Specialty Code for Ocularists MM6891
7110 09/17/2010 2010 Durable Medical Equipment Prosthetics, Orthotics, and Supply Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List MM7110
7066 09/24/2010 Durable Medical Equipment (DME) National Competitive Bidding (NCB) Implementation- Phase 11E: Remittance Advice (RA) and Medicare Summary Notice (MSN) Messages for Round One MM7066
6714 10/01/2010 Durable Medical Equipment (DME MAC) and the National Supplier Clearinghouse (NSC MAC) Procedures for Third Party Notification of Deceased Durable Medical Equipment, Prosthetic, Orthotic and Supplies (DMEPOS) Supplier Associates N/A
5574 04/03/2007 Program Instructions Designating the Competitive Bidding Areas and Product Categories Included in the CY 2007 DMEPOS Competitive Bid Program MM5574
5930 07/18/2008 VMS Recognition of New Specialty Codes for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) With Pedorthic Personnel, Medical Supply Companies With Pedorthic Personnel, and Rehabilitation Agencies. (DME MACs Only) N/A
5516 04/13/2007 Ventricular Assist Devices (VADs N/A
5571 04/13/2007 New DMEPOS Certificates of Medical Necessity (CMNs) and DME Information Forms (DIFS) for Claims Processing N/A
5579 05/25/2007 Adding Three CMS Specialty Codes for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) N/A
7213 04/08/2011 Implementation of New Reasonable Useful Lifetime (RUL) Policy for Stationary and Portable Oxygen Equipment N/A
7164 10/28/2010 Revision to Common Working File (CWF) Edit 729K to Deny Claims for Durable Medical Equipment (DME) Furnished to Beneficiaries in a Non-Part A Skilled Nursing Facility (SNF) Stay N/A
6908 10/28/2010 Implementation of Section 2902 of the Patient Protection and Affordable Care Act (the Affordable Care Act) for Indian Health Service (IHS) Part B Services and All Inclusive Rate (AIR) Billing for Return Visits N/A
7181 11/05/2010 January 2011 Quarterly Update for the DMEPOS Competitive Bidding Program. MM7181
7075 11/05/2010 National Council for Prescription Drug Programs (NCPDP) code set updates. N/A
7073 11/12/2010 Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) MM7073
5881 02/22/2008 ZIP Code Files by Date of Service N/A
7406 04/29/2011 VMS Utility Run for DME MACs Identification of Edits for ICD-10 N/A
7411 04/29/2011 New K codes for Suction Pumps and Wound Dressings N/A
7389 05/06/2011 Durable Medical Equipment National Competitive Bidding: Correction to Permit Payment for Certain Grandfathered Accessories and Supplies N/A
7248 11/24/2010 CY 2011 Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule N/A
6430 06/05/2009 Allow Zoned Program Integrity Contractor (ZPIC) to access Durable Medical Equipment Medicare Administrative Contractor (DME MAC) by ZPIC Zone N/A
6430 09/25/2009 Allow Zoned Program Integrity Contractor (ZPIC) to access Durable Medical Equipment Medicare Administrative Contractor (DME MAC) by ZPIC Zone N/A
6591 08/21/2009 5010-D.0 Project Receipt, Control and Balancing Initial Phase for Durable Medical Equipment (DME) Only N/A
6591 10/16/2009 5010-D.0 Project Receipt, Control and Balancing Initial Phase for Durable Medical Equipment (DME) Only N/A
6688 10/28/2009 Update to the Common Working File (CWF) Edits to Recognize the "";RA""; and "";RB""; Modifiers for Durable Medical Equipment (DME) Repairs and Replacements N/A
7397 05/13/2011 Pharmacy Billing for Drugs Provided, Incident To,a Physician Service MM7397
7212 05/13/2011 Edit to Deny Claims for Repairs to Capped Rental Durable Medical Equipment (DME) N/A
7425 05/20/2011 October 2011 Quarterly Update for the DMEPOS Competitive Bidding Program N/A
6720 11/13/2009 CY 2010 Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule MM6720
6566 12/23/2009 Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) MM6566
7248 12/09/2010 CY 2011 Fee Schedule Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) MM7248
7401 05/27/2011 Phase 3 of Manual Revisions to Reflect Payment Changes for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items as a Result of the DMEPOS Competitive Bidding Program and the Deficit Reduction Act of 2005 MM7401
7416 06/03/2011 July Quarterly Update for 2011 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule N/A
7410 09/30/2011 Proof of Delivery and Delivery Methods MM7410
6421 10/14/2011 Expansion of the Current Scope of Editing for Ordering/Referring Providers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplier (DMEPOS) Suppliers Claims Process by Durable Medical Equipment Medicare Administrative Contractors (DMEMACs) N/A
7625 10/27/2011 Revisions to Common Working File (CWF) Edits that Deny Claims for Prosthetics, Orthotics, and Supplies (POS) Furnished to Beneficiaries in a Skilled Nursing Facility (SNF) Stay N/A
7632 11/04/2011 January 2012 Quarterly Update for the DMEPOS Competitive Bidding Program MM7632
7635 11/04/2011 CY 2012 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule MM7635
7638 12/02/2011 April 2012 Quarterly Update for the DMEPOS Competitive Bidding Program N/A
7452 07/01/2011 Prospective Billing for Refills of DMEPOS Items Provided on a Recurring Basis N/A
7397 07/01/2011 Pharmacy Billing for Drugs Provided Incident to a Physician Service This CR rescinds and fully replaces CR 7109. N/A
7406 07/01/2011 VMS Utility Run for DME MACs identification of edits for ICD-10 N/A
7397 12/15/2011 Pharmacy Billing for Drugs Provided "Incident To" a Physician Service. This CR rescinds and fully replaces CR 7109. MM7397
7498 12/23/2011 Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: Allowing Contract or Non-contract Suppliers to Maintain and Service the Enteral Nutrition Equipment that They Provided in the 15th Continuous Month of Rental. MM7498
7389 07/14/2011 Durable Medical Equipment National Competitive Bidding: Correction to Permit Payment for Certain Grandfathered Accessories and Supplies N/A
7167 01/20/2012 Claims against Surety Bonds for Suppliers of Durable Medicare Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) MM7167
7397 08/05/2011 Pharmacy Billing for Drugs Provided Incident To a Physician Service. This CR rescinds and fully replaces CR 7109. N/A
7729 2012-03-09 Revision of Medicare Summary Notice (MSN) for Non-Competitive Bid Claims MM7729
7679 2012-03-23 2012 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction MM7679
7397 2012-04-04 Pharmacy Billing for Drugs Provided "Incident To" a Physician Service. This CR rescinds and fully replaces CR 7109. N/A
7822 2012-05-11 July Quarterly Update for 2012 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule MM7822
7768 2012-05-18 Quarterly Update for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program (CBP) – October 2012 MM7768
7749 2012-05-18 Internet Only Manual (IOM) Update for Laboratory Services and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Claims Processed under the End Stage Renal Disease Prospective Payment System (ESRD PPS) N/A
7749 2012-06-08 Internet Only Manual (IOM) Update for Laboratory Services and Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Claims Processed under the End Stage Renal Disease Prospective Payment System (ESRD PPS) N/A
7729 2012-08-03 Revision of Medicare Summary Notice (MSN) for Non- Competitive Bid Claims MM7729