Are Physicians Exempted with the DME Accreditation Requirements?
So “Who are exempted from the DMEPOS from accreditation and or surety bond?” for medical billing DME. This blog post will give you more clarification.
This article will focus only on Physicians and Non-Physician Practitioners and Providers also included are for the Physical Therapy and Occupation Therapy Service Providers:
According to the current guideline, the following are practitioners are exempted from the DMEPOS Accreditation and or Surety Bond and you need to understand why is that?
- Physician Assistants
- Registered Nutritionists and Dieticians
- Certified Midwife
- Clinicial Social Worker
- Clinical Psychologist
They are exempted ONLY when the Provider prescribe the item(s), supply or device to their own patients and as part of their own services for that particular patient
The Occupational and Physical Therapists are also Exempted from the accreditation process and surety bond only if ….
- The Physical Therapist or Occupational Therapist solely own and operates the business office;
- They provide the items and or services only to their own patients as part of their professional services rendered;
- They can only bill for orthotics, prosthetics and supplies.
Refer to below chart and get a bigger picture on Accreditation and Surety Bond Exemptions for DMEPOS.
Kindly see chart below which I have uploaded from =>> http://www.palmettogba.com/ncs and is last updated August 2009.
As far as I know, there are no new changes on this guideline.
I know that CHIROPRACTORS are NOT exempted from accreditation.
To locate the correct DMAC for each state – see below chart
Should you need help on how to complete a CMS-855s DMEPOS Form for your practice, contact me and I will help you.
- Read more about the Surety Bond Exemptions here – http://edocket.access.gpo.gov/2009/pdf/E8-30802.pdf
- Read more about the Accreditation Requirements here – http://www.cms.hhs.gov/MedicareProviderSupEnroll/Downloads/DMEPOSAccreditationMIPPA-FactSheet.pdf
Thinking of applying to become a DME Supplier and you are a Physician and or Physical Therapist? – You need to fill out CMS Form DMEPOS CMS-855s
CMS Form for DMEPOS CMS-855S – Download here! CMS 855s Form for DMEPOS Supplier Application for Medicare
Useful References for DME Durable Medical Equipment Billing and Reporting
To locate the correct DMAC for each state, see https://www.cms.gov/medicare-coverage-database/indexes/contacts-durable-medical-equipment-medicare-administrative-contractor-index.aspx
DME POS PLACE OF SERVICE CODES – https://med.noridianmedicare.com/web/jadme/claims-appeals/claim-submission/pos
DMEPOS FEE SCHEDULE – https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html
Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Standards – (please copy and paste the link) http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~National%20Supplier%20Clearinghouse~Supplier%20Enrollment~Standards%20Compliance~DMEPOS%20Supplier%20Standards~7GLS7Z1267
Medicare Enrollment Form for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers – (please copy and paste the link) – https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855s.pdf
Medicare Durable Equipment Claims Processing Manual https://www.mspinkymaniri.com/wp-content/uploads/2016/03/Chapter-20-Durable-Medical-Equipment-DMEPOS-Medicare-Claims-Processing-Manual-Rev-3196-02-13-15.pdf
If you would like to know on how you can increase revenue in your practice by becoming a DME Medicare Supplier based on the necessity shown above and as long as you provide them as a part of your patients services, CALL ME and I will show you how.
You might be interested in:
- Physical Therapy CPT Codes and the Medicare 8 Minute Rule in Physical Therapy Billing
- What is the CPT Code for Genicular Nerve Left Knee RFA or Destruction of Three Branches – superior medial and lateral branches and the inferior medial branch
- Improper DME Billing is on OIG 2018 Work Plan | Billing Off-the-shelf Orthotic Devices L0648, L0650, L1833 part of OIG 2018 Work Plan
- How to Report Claim for Prolonged Services when without Face to Face or No Direct Patient Contact
- Who are exempted from the DMEPOS accreditation and or surety bond | Are Physicians Exempted with the DME Accreditation Requirements