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CommercialReimbursementMedium impact

DME Reimbursement Update

Blue Cross Blue Shield of Wyoming·WY · Pulmonology, PM&R (Physical Medicine & Rehab), Orthopedics·Reimbursement
Effective date
Jun 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSWY is updating DME reimbursement rates effective June 1, 2025, based on Medicare's DMEPOS 2024 non-rural schedule. Respiratory equipment will be reimbursed at 140% of the fee schedule, while non-respiratory equipment will be reimbursed at 100%.

Action Required

Action needed
Before June 1, 2025: Billing team must update fee schedules and expected reimbursement amounts for all DME claims to reflect new rates - respiratory equipment at 140% of Medicare DMEPOS 2024 non-rural schedule and non-respiratory equipment at 100%. Update billing system calculations and patient financial counseling materials to reflect the new reimbursement structure.