WASHINGTON, D.C. – On November 29, 2025, the Centers for Medicare and Medicaid Services (“CMS”) posted a final rule making changes to the Medicare durable medical equipment, prosthetics, orthotics and supplies (“DMEPOS”) competitive bidding program. This final rule makes significant structural, bidding and other programmatic changes to the next round of competitive bidding.

CMS announced that for the next round of bidding, it will only be implementing Remote Item Delivery (“RID”) competitive bidding programs (“CBPs”), which will likely be national contracts for seven product categories, many of which have never been previously subject to competitive bidding. The seven product categories will be:

1. Class II Continuous Glucose Monitors (CGMs) and Insulin Pumps
2. Urological Supplies
3. Ostomy Supplies
4. Hydrophilic Urinary Catheters
5. Off-The-Shelf (“OTS) Back Braces
6. OTS Knee Braces, and
7. OTS Upper Extremity Braces

CMS will not be including any additional product categories in the next round of the CPB, such as oxygen, CPAP, standard wheelchairs, hospital beds, walkers, etc.

Competitive Bidding Program Rules That Have Not Changed

Furnishing of Items
Contractors are required to furnish items to any beneficiary who maintains a permanent residence in, or who visits, a CBA and requests those items from that contract supplier. Beneficiaries residing in a CBA must obtain competitive bid items from a contract supplier.

Disclosure of Subcontracting Arrangements
At the outset of the contract, and during the contract period, a contract supplier must disclose, within 10 days of when a supplier enters into a subcontract, information on any subcontracting arrangements and whether each subcontractor complies with the Medicare quality standards and accreditation requirements. The supplier must not contract with any entity that is currently excluded from the Medicare program, any state health care programs, or from any other federal government executive branch procurement or non-procurement program or activity. A contract supplier is permitted to subcontract the following duties: filling orders, delivery of CBP items, and repairing CBP items.

Breach of Contract
Any deviation from the contract requirements constitutes a breach of contract. In the event of a breach of contract, CMS may (a) suspend the contract supplier’s contract; (b) terminate the contract; (c) preclude the contract supplier from participating in the CBP; or (d) avail itself of other remedies allowed by law.

No Administrative or Judicial Review
Both the Social Security Act and CMS’ regulations preclude administrative or judicial review of the establishment of payment amounts, awarding of contracts, designation of competitive bidding areas, phase-in of the CBPs, selection of items for inclusion, bidding structure and number of selected contract suppliers.

HCPCS Code Changes After Contracts Begin
If a HCPCS code for a competitively bid item is revised after the contract period for a competitive bidding program begins, CMS will adjust the single payment amount for that item.

• If a single HCPCS code for an item is divided into two or more HCPCS codes for the components of the item, the sum of single payment amounts for the new HCPCS codes equals the single payment amount for the original
• If a single HCPCS code is divided into two or more separate HCPCS codes, the single payment amount for each of the new separate HCPCS codes is equal to the single payment amount applied to the single HCPCS code.
• If the HCPCS codes for components of an item are merged into a single HCPCS code for the item, the single payment amount for the new HCPCS code is equal to the total of the separate single payment amounts for the
• If multiple HCPCS codes for similar items are merged into a single HCPCS code, the items to which the new HCPCS codes apply may be furnished by any supplier that has a valid Medicare billing number.

Exceptions to the CBP
Physicians, treating practitioners and hospitals can furnish only certain items of DME without submitted a bid and being awarded a contract if the following conditions are met:

• The items are limited to crutches, canes, walkers, folding manual wheelchairs, blood glucose monitors and infusion pumps, and off the shelf orthotics.
• The items are furnished to the physician’s own patients as part of his/her professional service, or by a hospital to its own patients during admission or on the date of discharge.
• The items are billed under a billing number assigned to the hospital, physician or treating practitioner.
• Payment for the item is based on the competitive bidding program’s

RELATED
Competitive Bidding: A Summary – Part 1
Competitive Bidding: A Summary – Part 2
Competitive Bidding: A Summary – Part 3

Cara C. Bachenheimer, Esq., is an attorney with the Health Care Group at Brown & Fortunato, a law firm with a national health care practice based in Texas, where she heads up the firm’s Government Affairs Practice. Ms. Bachenheimer’s practice focuses on federal lobbying activities with Congress, the Administration, and federal regulatory agencies, such as CMS, FDA, IRS, and FAA. She can be reached at (806) 345-6321 or [email protected]

Jeffrey S. Baird, Esq., is chairman of the Health Care Group at Brown & Fortunato, PC, a law firm with a national health care practice based in Texas. He represents pharmacies, infusion companies, HME companies, manufacturers and other health care providers throughout the United States. Mr. Baird is Board Certified in Health Law by the Texas Board of Legal Specialization and can be reached at (806) 345-6320 or [email protected].