CMS Medicare Competitive Bidding Program

Centers for Medicare and Medicaid Services (CMS)

Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Medicare Competitive Bidding Program

The Centers for Medicare & Medicaid Services (CMS) has contracted with Palmetto GBA to operate as the Competitive Bidding Implementation Contractor (CBIC) to administer the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Palmetto GBA is responsible for conducting certain functions including performing bid evaluations, selecting qualified suppliers, setting payments for all competitive bidding areas, and supporting CMS education efforts. Palmetto GBA also assists CMS and its contractors in monitoring the program's effectiveness, access and quality.

Medicare Part B Competitive Bidding

Orthotics/Braces – the Background

  • In 2003, Congress originally authorized CMS to implement a Competitive Bidding Program (CBP) for DMEPOS. Multiple rounds of bidding have been conducted for many different DMEPOS categories over the past decade.
  • On November 3, 2018, CMS requested feedback on a proposal to include certain off-the-shelf (OTS) knee and back orthotics/braces in the next round of competitive bidding (known as Round 2021, since contracts will become effective on January 1, 2021).
  • In early 2019, CMS announced that OTS knee and back braces would be included in Round 2021.
  • OTS orthotics are defined as products that require minimal self-adjustment, and do not require expertise in trimming, bending, molding, assembling, or customizing to fit to the individual.

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