July 29, 2020 - BY Admin

Medicare relaxation on Durable Medical Equipment Billing to Fight COVID-19

Durable Medical Equipment (DME) | Home Medical Equipment (HME) | DMEPOS COVID Updates from Medicare (CMS) | Noridian COVID-19 update for DME | CGS COVID-19 update for DME

The US Government has issued an unparalleled arrangement of temporary regulatory waivers and new rules to provide the Healthcare system in order to respond to the Novel Coronavirus 2019 (COVID-19) pandemic. Here you can see what are the relaxation provided for Durable Medical Equipment (DME | HME) billing.

Generally, we need face-to-face requirement, a new physician’s order, and new medical necessity documentation are not required to get the another DME equipment in case of stolen, destroyed, lost, irreparable damaged. Due to this COVID-19, these documents are not required to get the equipment from the supplier. Suppliers can bill Medicare without these documents, but they need to mention the detailed information in the narrative stating why the replacement is required.

Some DME equipment required Prior Authorization from Medicare to bill the claim. CMS is temporary stopped the process and the supplier can bill the equipment without getting Prior Authorization.


DMEPOS certification enfranchisement: Getting certification enfranchisement is not required for newly enrolling suppliers and also CMS has extending the expiring certification enfranchisement for another 90 days.

Medicare Allowed amount increases: Medicare increased their allowed amount and they are reprocessing the claims from March 6, 2020, for adjusting the new fee schedule. Based on this Medicare will reprocess the claim which was paid already and increase the payment for certain Durable Medical Equipment POS products. (CARES Act,). You can visit this link for more information website:  https://www.cms.gov/Center/Provider- Type/Durable-Medical-Equipment-DME-Center.


Signature not required: In this COVID-19 situation Suppliers cannot able to get the signature from the patient in Delivery ticket, so Medicare is accepting the Delivery ticket even without having the patient's signature. But the DME supplier should maintain all other documents and records with the correct date of delivery properly.

The same way the DME equipment can give to the patient through a verbal order except for Power Mobility Devices. You can find more information in the below link to know more about how to bill the Power Mobility Device.

Official CMS website: https://www.cms.gov/about- cms/emergency-preparedness-response-operations/current-emergencies/coronavirus- waivers.

Visit us @ www.rcmadeptbillingsolutions.com