2026-01-22 - DMEPOS: Updated List of Items Potentially Subject to Conditions of Payment
AI Summary
CMS added 18 new items to the DMEPOS Master List that may require face-to-face encounters, written orders prior to delivery, or prior authorization. This includes 8 new oxygen items, 5 orthoses, and 2 pneumatic compression devices that could impact billing workflows.
Action Required
Immediately: Review the updated DMEPOS Master List PDFs to identify which oxygen items, orthoses, and pneumatic compression devices your practice provides. Update billing workflows to check if newly added items require face-to-face encounters, written orders prior to delivery, or prior authorization from your Medicare Administrative Contractor. Train staff to verify requirements before delivering DMEPOS items to prevent claim denials.
Affected Billing Codes
Plan Types
Traditional Medicare
Specialties
pm-r, ortho, pulmonology, general-practice, internal-medicine