It is true that with the introduction of lead item pricing, DMEPOS competitive bidding will be a lot more market-oriented in the coming years. While in the prior rounds, the single payment amount (SPA) for an item was equal to the median of the bids submitted for that item by the bidders, Round 2021 will be completely different.
The SPA for a lead item now will be equal to the maximum bid submitted for that item by the bidders. The lead item bids for the product category will be equal or below the pivotal bid for the product category in a competitive bidding area.
The product categories in Round 2021 will be 16 and the items newly included in the DMEPOS competitive bidding program are OTS back braces, knee braces and non-invasive ventilators. Bidding and payment methodology has changed completely with the introduction of lead item pricing with rates of payment and bids tied to the lead items assigned to each product category.
The guidelines for the suppliers interested for Round 2021
- All bidders in Round 2021 will be needed to obtain a bid surety bond in the amount of $50,000 for each competitive bidding area in which the bid gets submitted.
- It is important to note that the bid surety bonds required for bidding in the DMEPOS competitive bidding program will not be the same as the surety bonds required for the DMEPOS supplier enrollment purposes.
- All applicable licensing requirements have to be fulfilled with contracts only awarded to those bidders by the closing of the bid window.
- The changes of the licensing requirements change periodically with the responsibility lying with the bidder to identify obtain and have all the current, non-expired licenses reflecting in the PECOS by the close of the bid window.
- Also, each supplier location on a particular bid must be accredited by CMS-approved accrediting organization for the lead as well as the national lead items in a product category.
How Sun knowledge serves as a perfect DME billing destination
It is true that under the new CMS guidelines, DME providers will be able to make more money only if the plan early in the competitive landscape. They have to learn to engage with the patients in a more purposeful manner while simultaneously establishing a strong payment assurance strategy. Sun knowledge provides the perfect practice management support as a DME Billing Services Company and offers:
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Know more about our functional best practices, credentials on how we serve the benchmark as a disciplined healthcare revenue cycle management company. We are just a call away! Leverage the Sun knowledge advantage right now.