Process for billing DME, custom P&O medical supplies changing, starting July 1

After a few years of development, we’re now in the final stages of updating our claims processing system to align with the Centers for Medicare & Medicaid Services’ off-the-shelf policy.

Starting July 1, 2018, all durable medical equipment and medical supply providers who bill for custom prosthetic and orthotic services will be required to bill claims with a separate, CMS-accredited P&O provider PIN. If you bill for custom P&O HCPCS codes and you don’t submit your claim with a separate, CMS-accredited, P&O PIN, your claims will reject as “provider liable.” If you don’t already have your CMS-accredited P&O provider PIN, you can get more information by visiting the National Supplier Clearinghouse** website.

CMS does allow DME, P&O and medical supply providers to bill for specific off-the-shelf orthotic HCPCS codes without any accreditation requirement.

If you still need to update your provider certification information with Blue Cross Blue Shield of Michigan, contact Provider Enrollment and Data Management at 1-800-822-2761.

** Blue Cross Blue Shield of Michigan doesn’t own or control this website.