tci Medicare Compliance & Reimbursement - 2004 Issue 43
DME: Suppliers Declare Victory On Face-To-Face Exams Dispute
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Article Overview
This article reviews a CMS physician fee schedule update affecting durable medical equipment suppliers, pharmacies, and homecare stakeholders. It focuses on the finalized monthly and multi-month dispensing fees for inhalation drugs, the sources CMS relied on in setting those amounts, and the postponement of a controversial face-to-face examination requirement for DMEPOS ordering and renewal. The piece is relevant to billing, reimbursement, and compliance professionals following Medicare policy changes.
Why This Topic Matters
The article highlights payment and coverage-policy developments that may affect reimbursement, supplier operations, and ordering workflows for DMEPOS and inhalation-drug dispensing. It is useful for organizations tracking CMS rulemaking and anticipating future policy changes.
Article Sections
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Dispensing fee finalized for inhalation drugs
Discusses CMS payment updates in the physician fee schedule and the general basis for the finalized dispensing fee policy. It also notes that the issue remains under further review.
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Face-to-face exam requirement delayed
Covers the postponement of a CMS requirement involving physician face-to-face examinations before certain DMEPOS orders or renewals. The section places the delay in the context of public comments and future rulemaking.
What You Will Learn
- How the article frames CMS payment updates affecting inhalation-drug dispensing
- What kinds of policy issues are discussed for durable medical equipment suppliers
- Why the face-to-face examination requirement was delayed
- Which stakeholder groups are referenced in the context of the rulemaking
Who Should Read This
- Durable medical equipment suppliers
- Pharmacies
- Homecare providers
- Medical billing and coding professionals
- Compliance teams tracking Medicare rules
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