CMS Includes OTS Orthoses in 2021 Competitive Bidding

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The Centers for Medicare and Medicaid Services (CMS) announced that 16 off-the-shelf (OTS) spinal orthosis Healthcare Common Procedure Coding Systems (HCPCS) codes and seven OTS knee orthosis codes will be included in the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) Competitive Bidding Program for dates of service on or after January 1, 2021.

CMS said that the addition of the orthoses is due to its shifting of some items to different, smaller product categories to accommodate the lead item pricing methodology.

The spinal orthosis codes are L-0450, L-0455, L-0457, L-0467, L-0469, L-0621, L-0623, L-0625, L-0628, L-0641, L-0642, L-0643, L-0648, L-0649, L-0650, and L-0651.

The knee orthosis codes are L-1812, L-1830, L-1833, L-1836, L-1850, L-1851, and L-1852.

A temporary gap period in the Competitive Bidding Program began on January 1 after the expiration of all program contracts on December 31, 2018. CMS expects the gap will last through December 31, 2020, and set the following timeline to assure that competitive bidding for 2021 will begin on time:

·        March 7: CMS begins pre-bidding supplier awareness program.

·        May: CMS announces dates for registration and bidding and begins bidder education program.

·        June: Bidder registration period begins and bid windows open.

For more information, visit the DMEPOS Competitive Bidding Round 2021 Fact Sheet on the CMS website.