AAHomecare Shares 2023 Fee Schedule Analysis for Top 25 DME Items

WASHINGTON, D.C. – Last week, CMS published the 2023 Medicare DMEPOS fee schedule. The fee schedule reflects the 6.4% to 9.1% CPI-U adjustments published earlier this month.

AAHomecare’s analysis of the top 25 DME items shows the following average rate increases for CY 2022 compared to rates currently in place:

• CBP items in former CBAs: +6.4%(ranging from 5.1%-7.5%)
• CBP items in non-rural areas: +8.7%(ranging from 6.3%-10.2%)
• CBP items in rural areas: +8.4%(ranging from 4.2%-8.9%)

The CY 2023 CPI-U increase is applied to the current public health emergency (PHE) relief rates of 75/25 blended rates in non-rural areas and 50/50 blended rates in rural areas.

You can download AAHomecare’s top 25 HCPCS codes analysis (Excel spreadsheets) here:

• CY 2023 Top 25 DME Items Former CBA Fee Schedule Analysis
• CY 2023 Top 25 DME Items Rural and Non-Rural Fee Schedule Analysis

Updated Payer Letter on Current Cost and Operational Challenges Available

WASHINGTON, D.C. – AAHomecare’s Payer Relations team has updated a letter on the market and operational realities for the HME sector to use in your engagement with private payers.  The letter highlights some of the significant cost increases and other challenges facing suppliers nationwide that you can use in conjunction with sharing examples from your own experiences.

See our Payer Engagement Resources page for more tools to help you educate your payers about your market environment and the value of HME.

Year-End Regulatory Council Session Covers Broad Range of Issues

WASHINGTON, D.C. – AAHomecare’s Regulatory Council held its final 2022 quarterly meeting last week to discuss progress on current Council initiatives and set goals for the year ahead.

Current regulatory initiatives underway include developing comments on the Dual Eligible RFI, a proposed rule on Prior Authorization for Medicare Advantage, and responding to an OIG report on CPAP devices.  Other ongoing areas of focus for the Council include UPIC audits on PHE claims, issues with CMS retroactively denying Part B payments when patients are in a Part A stay, and guidance related to the recent Oxygen LCD.

The Council will also be closely monitoring issues arising from the expected post-PHE transition in 2023, working to reduce the ALJ appeals backlog, and responding to any developments in restarting the competitive bidding program.