Cms dmepos supplier manual

Medicare Program Integrity Manual Chapter 5 – Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items and Services Having Special DME Review Considerations. Table of Contents (Rev. , ) Transmittals for Chapter 5. – . Supplier Manual The information previously consolidated into Supplier Manual Chapters is now located in the website for improved access to individual topics. The contents of each chapter with hyperlinks to access individual topics is provided below. Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers must meet the Centers for Medicare Medicaid Services (CMS) DMEPOS Quality Standards under the Medicare Modernization Act of (MMA).

Under current gap filling guidelines outlined in Chapter of the Medicare Claims Processing Manual, Medicare establishes a new fee schedule amount based on (1) the fee schedule amount for a comparable item in the DMEPOS fee schedule, or (2) supplier price lists or retail price lists, such as mail order catalogs, with prices in effect during the base year. A DMEPOS supplier must meet certain requirements and enroll as described in Chapter 10 of the Program Integrity Manual. A provider that enrolls as a supplier is considered a supplier for DMEPOS billing. However, separate payment remains restricted to those items that are not considered included in a PPS rate. MEDICARE DMEPOS SUPPLIER STANDARDS Note: This is an abbreviated version of the supplier standards every Medicare DMEPOS supplier must meet in order to obtain and retain their billing privileges. These standards, in their entirety, are listed in 42 C.F.R. (c). 1.

1. okt South Carolina (SC) Medicaid allows diabetic meters and strips to be billed under the DME. POS, the CMS claim form or the SC Medicaid Web-. affecting a Medicare provider number is important to ensure that all CMS requirements involving a Medicare provider or supplier, parties to the. This manual contains an overview of important and useful information for DMEPOS suppliers regarding the Medicare program.