Traditional MedicareBilling CodesHigh impact
R13956CP: October Quarterly Update for 2026 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule
Medicare/CMS - Transmittals·CMS Transmittal
Effective date
Oct 1, 2026
We identified it
Sep 30, 2026
Summary
CMS has released the October 2026 quarterly update to the DMEPOS fee schedule, effective October 1, 2026. This update adds six new HCPCS codes (A4228, A6614, E0150, E0788, E2403, L1972), deletes one code (L8696), updates fee schedule amounts for former Competitive Bidding Areas with a 2.8% CPI-U adjustment, and modifies the DMEPOS Rural ZIP code file. Billing teams must update systems to reflect new code pricing and deleted codes to avoid claim denials.
Action Required
By October 5, 2026 (implementation deadline), the billing team must: (1) Add the six new HCPCS codes (A4228, A6614, E0150, E0788, E2403, L1972) to the billing system's fee schedule with their established payment amounts; (2) Remove HCPCS code L8696 from the billing system effective September 30, 2026—do not process claims for this code on or after October 1, 2026; (3) Update fee schedule amounts for items furnished in former Competitive Bidding Areas with the 2.8% CPI-U increase for calendar year 2026; (4) Refresh the DMEPOS Rural ZIP code file (Quarter 4 update) and the Former CBA ZIP code file in the system to ensure correct geographic-based pricing; (5) Update billing software validation rules to use the new fee schedule files. Failure to update will result in incorrect reimbursement, potential underbilling for new codes, and claim denials for deleted code L8696. Verify all changes are live before October 1, 2026 date of service.