This Should Be of Major Interest To Medicare Beneficiaries

If you are on Medicare and in Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, Virginia, Wisconsin or West Virginia the folloing URL will reveal the Medicare allowed amount for your equipment - the one catch is that you must know the HCPCS code. For a straight CPAP (and Auto) the code is E0601 (page 12 of this URL).

http://www.adminastar.com/Providers/DME ... uarter.pdf

In Michigan the capped rental fee is $99.95 a month for a CPAP or Auto.

Another very useful site for all DME products is:
http://www3.palmettogba.com/dmecs/do/search
This search function will permit you to search by manufacturer and/or product code to obtain the HCPCS code. You can then enter the HCPCS code into the fee schedule search and look by state and "purchase date".

Cheers,

Palmetto covers a different region. The HCPCS codes will be the same but the fees allowed can and at times do differ from the area I cited above. Thank you for adding Palmetto's URL. Its for some of the SE states I'm pretty sure but I'm not sure WHICH states.

And whilst we are at it, Medicare enrollees can access information on their claims at mymedicare.com. You do have to register and it can take 10 days to 2 weeks to receive a letter granting access and verifying your PIN. But from then on in you are home clear

Hi Slinky,
Yes the Palmetto does serve certain states, however, after looking up the fee schedule the dialog box at the bottom allows you to chose states
that are in other jurisdictions other than palmetto.
Good info to have!

I totally agree, dataq1!!!

Even for those not on Medicare it gives them some idea of the prices that their insurance company negotiates w/these DMEs. AND as mentioned the codes remain the same thru out, Medicare or private insurance, no matter the state (any exceptions noted at the cited websites).

The other thing that should be of major interest is the effort by CMS (Centers for Medicare and Medicaid) to put the DME business on a competitive bid basis.
The DME "industry", among others is very opposed to the notion. They base their objection on the concept that CMS is trying to create a "super" DME, one that would price and dispense all equipment from one source.

The other interpretation of this effort is to get more realistic pricing of equipment. A great many of the goods that we use did not exist in 1987-1988, so the current fee schedule tends not to represent the actual cost to produce and market these goods.

I've been trying to keep up with this news (and at the same time "translate" to everyday english the announcements) about the competitive bid program.

So.... if anyone has more information from reliable sources, please pass it along.
Cheers for now,