CMS issues rule with DME provisions

WASHINGTON – CMS on June 30 issued a home health proposed rule that codifies returning Medicare rates for DME in non-rural/non-CBAs to levels prior to regulatory and legislative relief during the public health emergency. 

The CY 2024 Home Health Prospective Payment System Rate Update, expected to be published in the Federal Register on July 10, also contains several other DME related provisions: 

Lymphedema compression garments 

The proposed rule establishes a Medicare Part B benefit for standard and custom-fitted gradient compression garments and other compression treatment items, for the treatment of lymphedema that are prescribed by an authorized practitioner. It would, among other things, define what constitutes a standard- or custom-fitted gradient compression garment and identify other compression items used for the treatment of lymphedema that would fall under the new benefit category, beginning Jan. 1, 2024. 

Braces 

The proposed rule would also codify the longstanding Medicare definition of brace to provide clarification on the scope of the Medicare Part B benefit for leg, arm, back and neck braces, and as a result, would classify certain exoskeleton-type devices as braces for Medicare payment purposes. 

Refills 

The proposed rule would codify CMS’s long-standing refill policy, with some changes. It would require documentation indicating that the beneficiary confirmed the need for the refill within the 30-day period prior to the end of the current supply. Additionally, it would codify the requirement that delivery of DMEPOS items (that is, date of service) be no sooner than 10 calendar days before the expected end of the current supply.  

• Read a fact sheet on the rule here.