CMS Announces 5%+ CPI Adjustments for DME in 2022

WASHINGTON, D.C. (December 2, 2021)—The Centers for Medicare & Medicaid Services (CMS) published fee schedule adjustments for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) for calendar year (CY) 2022. Adjustments differ depending on whether the items serviced are competitive bidding program (CBP) items or in former competitive bidding areas (CBAs). Below is the breakdown:

CBP items in former CBAs: +5%
CBP items in non-CBAs: +5.4%
Non-CBP items: +5.1%

“While suppliers will welcome these increases, the DME community still needs additional rate adjustments to account for the widespread product price hikes, shipping surcharges and new operational requirements that have increased costs for our industry,” said Tom Ryan, AAHomecare president and CEO. “Suppliers need Medicare reimbursement rates that truly reflect the market realities they face.”

“What’s more, these increases will essentially be cancelled out unless Congress takes action to waive looming 4% PAYGO-driven cuts for FY 2022 and extend the pause on the 2% Medicare sequester until the end of the ongoing public health emergency,” Ryan added. “Cutting reimbursements during a pandemic doesn’t make sense and we need to make sure Capitol Hill gets that message.”

Typically, the Consumer Price Index (CPI) increases for DME have been 1%-3%. Last year, the inflation adjustment was less than 1%.

In addition, CMS affirmed the continued adjustments for rural and other non-bid area relief included in the Cares Act as follows:

“Since the public health emergency has not ceased, the update for the 2022 DMEPOS and PEN fee schedule files continue to include the rural and non-contiguous non-CBA 50/50 blended fees and the non-rural contiguous non-CBA 75/25 blended fees required by section 3712 of the CARES Act.”

CMS will be publishing the official CY 2022 fee schedule soon. See the Calendar Year 2022 Update for DMEPOS Fee Schedule (CMS’s Claims Processing Update Change Request 12521) for more information.