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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. 

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