CMS releases 2019 fee schedule adjustments

Friday, December 14, 2018

WASHINGTON – CMS’s 2019 fee schedule provides a “modest” 2.5% CPI-U increase to single payment amounts for DME in former competitive bidding areas, according to AAHomecare.

The fee schedule also provides a 2.5% increase to SPAs for diabetes supplies as part of the mail-order program.

It provides a 2.3% increase to current rates for DME not included in the bid program.

As previously determined, by a final rule, DME in rural/non-contiguous areas will be paid a 50/50 blended reimbursement rate.

“While adjustments to keep pace with inflation are certainly welcomed by home medical equipment suppliers, they do nothing to offset the deep reimbursement cuts produced by the bidding program over the last seven years,” said Tom Ryan, president and CEO of AAHomecare. “Even with the games for rural suppliers and reforms for future rounds of the bidding program achieved in 2018, this fee schedule update reminds us that we are a long way from a sustainable Medicare reimbursement environment.”

AAHomecare pointed out that this round of adjustments is the highest applied since the bid program took effect. Previous increases have averaged 1.3%, with a high of 2.1% in 2015.

The association has reached out to CMS for clarification on whether non-rural areas outside of the former bid areas will get the indirect benefit of the CPI increase in the former areas.