By and large, there are not many notable differences in payment between 2017 and our current prices. CMS deployed a 0.7% increase to general DME items, but with the rollout of Round 2 Recompete, the bid pricing factored a further reduction for all items subject to competitive bid nationwide. For exempt DME you will see a minimal increase, but for bid products you will likely see a minimal DECREASE.
However, the rates for stationary oxygen did notably decrease netting an $8-9 reduction based on how CMS calculates oxygen payments. Per statute, when CMS added a separate payment class for oxygen generating portable equipment in 2006, they required that each year the stationary and portable oxygen contents be reassessed to remain budget neutral. This protocol forced additional cuts to the stationary, however it is not apparent why this resulted in such a notable decrease.
However, the rates for stationary oxygen did notably decrease netting an $8-9 reduction based on how CMS calculates oxygen payments. Per statute, when CMS added a separate payment class for oxygen generating portable equipment in 2006, they required that each year the stationary and portable oxygen contents be reassessed to remain budget neutral. This protocol forced additional cuts to the stationary, however it is not apparent why this resulted in such a notable decrease.
Based on historical analysis of rate changes within oxygen over the last few years, this reduction does seem like an anomaly, potentially suggesting an error in the calculation. Several industry stakeholders claim have asked CMS to share the actual mathematics involved in determining payment rates for E1390. Stay tuned for further developments.
This is a rough comparison of sampled DMEPOS Fee Schedule rates from 2014 to 2017 for oxygen:
E1390, Oxygen Concentrator
1/2014 $178.24
1/2015 $180.92
1/2016 $141.74 rural $135.14 non-rural
7/2016 $86.61 rural $74.40 non-rural
1/2017 $77.16 rural $66.53 non-rural
E0431, Portable Gaseous Oxygen System
1/2014 $29.97
1/2015 $30.42
1/2016 $25.89 rural $24.75 non-rural
7/2016 $19.19 rural $16.63 non-rural
1/2017 $19.03 rural $16.59 non-rural
E1392/K0738, Portable Oxygen Concentrator
1/2014 $51.63
1/2015 $51.63
1/2016 $49.27 rural $46.69 non-rural
7/2016 $42.16 rural $36.41 non-rural
1/2017 $41.91 rural $36.14 non-rural
E0443, portable gas contents
1/2014 $77.45
1/2015 $77.45
1/2016 $69.22 rural $65.57 non-rural
7/2016 $52.96 rural $44.29 non-rural
1/2017 $52.61 rural $44.17 non-rural
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