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HHS/CMS RIN: 0938-AU17 Publication ID: Spring 2021 
Title: Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Policy Issues and Level II of the Healthcare Common Procedure Coding System (HCPCS) (CMS-1738) 
Abstract:

This final rule establishes methodologies for adjusting the Medicare DMEPOS fee schedule amounts using information from the Medicare DMEPOS competitive bidding program for items furnished on or after April 1, 2021, or the date immediately following the duration of the emergency period described in section 1135(g)(1)(B) of the Social Security Act, whichever is later. Among the issues under consideration for this final rule would be to establish procedures for making benefit category and payment determinations for new items and services that are durable medical equipment (DME), prosthetic devices, orthotics and prosthetics, therapeutic shoes and inserts, surgical dressings, or splints, casts, and other devices used for reductions of fractures and dislocations under Medicare Part B. In addition, this rule considers classifying continuous glucose monitors (CGMs) as DME under Medicare Part B and establish fee schedule amounts for these items and related supplies and accessories. This rule would also consider finalizing conforming changes to the regulations related to implementation of section 106 of the Further Consolidated Appropriations Act, 2020.

 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Long-Term Actions 
Major: Yes  Unfunded Mandates: No 
CFR Citation: 42 CFR 414   
Legal Authority: 42 U.S.C. 1395l    42 U.S.C. 1395m    42 U.S.C. 1395u    42 U.S.C. 1395w-3   
Legal Deadline:
Action Source Description Date
Final  Statutory  MMA sec. 902 requires Medicare final rules publish within 3 years of a proposed or interim final rule.  11/04/2023 

Overall Description of Deadline: Per the CMS notice published December 30, 2004 (69 FR 78442), except for certain Medicare payment regulations and certain other statutorily-mandated regulations, we schedule all Medicare final regulations for publication within the 3-year standardized time limit in the current Unified Agenda. We do not intend to delay publishing a Medicare final regulation for 3 years if we are able to publish it sooner.

Timetable:
Action Date FR Cite
NPRM  11/04/2020  85 FR 70358   
NPRM Comment Period End  01/04/2021 
Final Action  11/00/2023 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Federal, State 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Related RINs: Related to 0938-AT21 
Agency Contact:
Joel Kaiser
Director, Division of DMEPOS Policy
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare, MS: C5-07-26, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-6506
Email: joel.kaiser@cms.hhs.gov