Adding additional products to your DMEPOS business is a great opportunity for you to increase the number of patients you can serve in your community. The DMEPOS competitive bid gap, currently anticipated to last through December 31, 2020, has created an expanded market for DMEPOS suppliers to add products that previously could only be dispensed by bid winners.

The Compliance Team has received requests from many of our DMEPOS suppliers about adding products. We want to offer guidance, as well as outline the process for requesting additional product approval.

Requesting Additional Products

• Contact Kelly Haggerty (our National Scheduler) at KHaggerty@thecomplianceteam.org via email. Include your company name and the specific products, including HCPCS codes, requested.
• Kelly will respond to let you know whether the product can be added via a file review* or if an on-site visit is required, and the associated charge. She will also send the necessary paperwork, and an “add product” checklist for use to be sure all elements are met.
• Be aware that the addition of some equipment may elevate your business to a different program level, with a resulting change in program fees.

*Please note that any paperwork sent in for a file review must not include any Patient Health Information.

Must Do’s before making the decision

• Assess the number of patient/clients in your area that would be likely to use these additional products.
• Contact referrals to see if they would choose your company for this expanded line of DME.
• Review the state licensure database on the National Supplier Clearinghouse website (www.palmettogba.com/nsc) to determine if state license or licensed personnel is required for the products you wish to add.
• Review the HCPCS codes that you are considering adding on the DME PDAC website (www.dmepdac.com) to determine whether the item is categorized as capped rental, inexpensive or routinely purchased, supply, etc. If adding orthotic/prosthetic products, be sure to verify whether the item is identified as off-the-shelf, prefabricated, or custom. Some states require licensed personnel for off-the shelf items, and the majority require licensed personnel for prefabricated and custom items.
• Review any relevant “Local Coverage Determinations” and/or “Documentation Checklists” on your DME MAC website to ensure a good understanding of the required elements for coverage.
• Review the Compliance Team DMEPOS Quality Standards to ensure that all evidence of compliance is met for relevant quality standards.
• Whether adding via file review, or on-site, your Accreditation Advisor will need to verify that your company has provided training to staff on the new products, customized related policies and procedures, created any needed forms and addressed any specialty quality standards that must be met (e.g., prefabricated/custom orthotics and prosthetics have additional quality standards in addition to general DME standards).
• Following the review and approval of any additional products, providers are responsible to update the PECOS account to reflect the additional products.

• Our Accreditation Programs
  
  
  • Rural Health Clinic
    (Medicare approved)
  • Patient Centered Medical Home
  • Immediate Care Clinic
  • DMEPOS
    (Medicare approved)
  • Ocularist/Anaplastologist
  • Pharmacy Services
    Community Pharmacy including Medicare Approved DMEPOS
    Sterile Compounding
    Non-sterile Compounding
    Long-Term Care
    Specialty Drugs
    Infusion
    Travel/Retail Clinic