CMS Releases CPI-U Adjustments For DMEPOS In 2025 And Fee Schedule Q1

Published in Government Relations on December 16, 2024

CMS released the annual inflation factor to be applied to DMEPOS items effective Jan. 1, 2025, with an implementation date of Jan. 6, 2025. The breakdown of the adjustment is dependent upon whether the serviced items are included in the competitive bidding program (CBP) or are in formerly competitive bid areas (CBAs) such as rural and non-rural.  

  • CBP items in former CBAs: +2.9%  
  • CBP items in non-CBAs: +3%  
  • Non-CBP items: +2.4%  

In the current environment, the DMEPOS industry welcomes any increased adjustments to the fee schedule allowables. Even though there is still some ground to cover by getting the allowables adjusted to reflect the higher costs for operational expenses and higher product costs, the increase is welcomed.  

Other Noteworthy Updates: 

  • Lymphedema Items 
    • Some items within this category will see a 3% increase. 
  • Therapeutic Shoes 
    • Updates being made to A5503 – A5507, as well as A5512, A5513, A5514. 
  • Diabetic Testing Supplies 
    • Updates to mail order diabetic testing supplies billed with the KL modifier. 
  • Oxygen Maintenance And Service (MS modifier)  
    • 2.4% increase yielding an allowable of $87.82. 
  • Labor/Repair/Service Codes (K0739, L4205, L7520)  
    • 3% increase. 

CMS has released the DMEPOS fee schedule for Q1 2025. The PDAC will get their updates completed soon. The meantime the allowables can be found using this link

Support DME Legislation as the 118th Congress Concludes  

As the 118th Congress draws to a close, we urgently need your help. Congressional negotiations are currently underway to determine the scope of end-of-year health and budget legislation. We are optimistic that the DME Legislation (H.R. 5555 and S. 1294) will be included in the final legislative package, but your support is crucial to ensure this happens!  

What You Can Do

Please reach out to your legislator’s health staffer in both the Senate and the House, either by phone or email, and urge them to “support the inclusion of H.R. 5555 and/or S. 1294 in any end-of-year package.” You can easily send a message by clicking on this link: Action Center | VGM & Associates. You are able to edit the message and add personal reasons why this legislation is important to your customers, your business, and all users of DME.  

Thank you for being the voice of the DME industry! Your efforts are vital in getting this legislation across the finish line.  

From Our Experts

You Got The Contract! …Now What?! Part 2: Contract Maintenance thumbnail You Got The Contract! …Now What?! Part 2: Contract Maintenance In our last article, we discussed the key provisions to be sure you know about your contract. It is critical to understand these provisions to help comply with the contract terms, fulfill your obligations as your business changes, and understand the payer's obligations and your rights under the contract. In this article we discuss some best practices for managing your contracts once you get them. Industry Uncertainty And Advocacy Needs – What You Can Do NOW thumbnail Industry Uncertainty And Advocacy Needs – What You Can Do NOW The proposed rule introduces broad structural changes without full clarity on implementation timelines or enforcement. Industry groups like VGM, AAHomecare, and CQRC are urging stakeholders to engage in advocacy to shape final rules. To prepare for the sweeping changes in the 2025 CMS Proposed Rule for DMEPOS, companies should take a multi-pronged strategic approach. Here is a breakdown of key preparation strategies: Alabama Durable Medical Equipment Association (ADMEA) Seeks New Executive Director thumbnail Alabama Durable Medical Equipment Association (ADMEA) Seeks New Executive Director The Alabama Durable Medical Equipment Association (ADMEA) is now accepting applications for the role of Executive Director. This is an exciting leadership opportunity for an individual with a passion for healthcare, industry advocacy, and association management. 2025 CMS Proposed Rule Challenges and To-Dos thumbnail 2025 CMS Proposed Rule Challenges and To-Dos The 2025 CMS Proposed Rule for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) introduces several significant changes that present both operational and financial challenges for DME companies. You Got the Contract! …NOW WHAT?! A Short Series thumbnail You Got the Contract! …NOW WHAT?! A Short Series Congratulations! You FINALLY got the contract you've been working so hard on all these months. Now that you have it, what are the critical next steps you need to take to maintain and implement the contract and generate ROI? Welcome to the first of a short series of articles to help you accomplish just that. NAAOP Hosts First Ever In-Person Legislative Fly-In thumbnail NAAOP Hosts First Ever In-Person Legislative Fly-In Last week, 33 stakeholders, advocates, and leaders from around the O&P industry convened at the offices of Powers Pyles Sutter & Verville PC in Washington, D.C., as part of The National Association for the Advancement of Orthotics and Prosthetics's (NAAOP) first ever in-person legislative fly-in. Co-sponsored by OPGA, the fly-in kicked off with an in-depth discussion and strategy session surrounding several legislative priorities affecting O&P providers and patients. VGM Government Relations Unveils Grassroots Advocacy Toolkit to Empower DME Champions of Change thumbnail VGM Government Relations Unveils Grassroots Advocacy Toolkit to Empower DME Champions of Change The VGM Government Relations team is proud to announce the launch of its Grassroots Advocacy Toolkit, thoughtfully crafted to support durable medical equipment (DME) professionals, caregivers, industry partners, and patient advocates in advancing legislative initiatives that impact home medical equipment and services. Featuring Two Champions Of Change: Robert Beard of YD Home Medical & Rob Minicucci Jr. of Health System Services thumbnail Featuring Two Champions Of Change: Robert Beard of YD Home Medical & Rob Minicucci Jr. of Health System Services Today, we're proud to spotlight two outstanding durable medical equipment (DME) champions whose advocacy efforts are making a meaningful difference: Robert Beard of YD Home Medical of Alabama and Rob Minicucci Jr. of Health System Services of New York. These individuals took time out of their busy schedules to personally connect with elected officials, demonstrating how local action can spark national change.