We’re changing the way we process DME HCPCS codes, effective March 1, 2018

Effective March 1, 2018, Blue Cross Blue Shield of Michigan is changing how we process durable medical equipment HCPCS codes. We’re adding four categories to explain how we’ll pay for DME:

• Capped rental
• Purchase only
• Rent forever
• Short-term rental

We’re also expanding the capped rental and reasonable useful lifetime time frame.

The DME capped rental period is expanding from 10 monthly payments to 13 monthly payments. After 13 monthly payments, the equipment will be considered purchased.

The reasonable useful lifetime for purchased DME is expanding from every three years to five years. This aligns with Centers for Medicare & Medicaid Services policy.

These changes will result in updates to the rental fees, specifically for the capped rental HCPCS codes. These changes will be incorporated into the newly published DME/P&O Fee Schedule, effective March 1, 2018.

You can access the fee schedule via web-DENIS.

• Log in to web-DENIS.
• Click on BCBSM Provider Publications and Resources.
• Click on Entire Fee Schedules and Fee Changes.

In a web-DENIS alert and in the January Record, we’ll be publishing a list of the DME HCPCS codes in each of the four categories.