{"abstract":"This proposed rule would establish methodologies for adjusting the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule amounts using information from the Medicare DMEPOS competitive bidding program for items furnished on or after April 1, 2021, or the date immediately following the duration of the emergency period described in section 1135(g)(1)(B) of the Social Security Act, whichever is later; application evaluation processes and other procedures related to Healthcare Common Procedure Coding System (HCPCS) Level II code applications; and procedures for making benefit category and payment determinations for new items and services that are durable medical equipment (DME), prosthetic devices, orthotics and prosthetics, therapeutic shoes and inserts, surgical dressings, or splints, casts, and other devices used for reductions of fractures and dislocations under Medicare Part B. In addition, this rule proposes to classify continuous glucose monitors (CGMs) as DME under Medicare Part B and establish fee schedule amounts for these items and related supplies and accessories. Also, this proposed rule would expand the scope of the Medicare Part B benefit for DME by revising the interpretation of the \"appropriate for use in the home\" requirement in the definition of DME specifically for certain drugs or biologicals infused in the home using an external infusion pump. This proposed rule would also make conforming changes to the regulations related to implementation of section 106 of the Further Consolidated Appropriations Act, 2020.","action":"Proposed rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2020/11/04/2020-24194.html","cfr_references":[{"chapter":null,"citation_url":null,"part":"414","title":42}],"citation":"85 FR 70358","comment_url":null,"comments_close_on":"2021-01-04","correction_of":null,"corrections":[],"dates":"To be assured consideration, comments must be received at one of the addresses specified in the ADDRESSES section, no later than 5 p.m. on January 4, 2021.","disposition_notes":null,"docket_ids":["CMS-1738-P"],"dockets":[],"document_number":"2020-24194","effective_on":null,"end_page":70414,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2020/11/04/2020-24194.xml","html_url":"https://www.federalregister.gov/documents/2020/11/04/2020-24194/medicare-program-durable-medical-equipment-prosthetics-orthotics-and-supplies-dmepos-policy-issues","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2020-24194?publication_date=2020-11-04","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2020-11-04/2020-24194/mods.xml","not_received_for_publication":null,"page_length":57,"page_views":{"count":8418,"last_updated":"2026-10-23 02:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2020-11-04/pdf/2020-24194.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2020-24194.pdf?1604002525","publication_date":"2020-11-04","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2020/11/04/2020-24194.txt","regulation_id_number_info":{"0938-AU17":{"issue":"202010","html_url":"https://www.federalregister.gov/regulations/0938-AU17/durable-medical-equipment-prosthetics-orthotics-and-supplies-dmepos-policy-issues-and-level-ii-of-th","title":"Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Policy Issues and Level II of the Healthcare Common Procedure Coding System (HCPCS) (CMS-1738)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=202010&RIN=0938-AU17&operation=OPERATION_EXPORT_XML","priority_category":"Other Significant"}},"regulation_id_numbers":["0938-AU17"],"regulations_dot_gov_info":{"supporting_documents":[],"regulatory_plan":{"html_url":"https://www.federalregister.gov/regulations/0938-AU17/durable-medical-equipment-prosthetics-orthotics-and-supplies-dmepos-policy-issues-and-level-ii-of-th","title":"Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Policy Issues and Level II of the Healthcare Common Procedure Coding System (HCPCS) (CMS-1738)"},"comments_count":117,"agency_id":"CMS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2020-0128","supporting_documents_count":0,"docket_id":"CMS-2020-0128","document_id":"CMS-2020-0128-0001","regulation_id_number":"0938-AU17","title":"Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Policy Issues and Level II of the Healthcare Common Procedure Coding System (HCPCS) (CMS-1738-P)","checked_regulationsdotgov_at":"2021-01-11T04:30:13Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":70358,"subtype":null,"title":"Medicare Program; Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Policy Issues and Level II of the Healthcare Common Procedure Coding System (HCPCS)","toc_doc":"Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Policy Issues and Level II of the Healthcare Common Procedure Coding System","toc_subject":"Medicare Program:\n","topics":["Administrative practice and procedure","Biologics","Diseases","Drugs","Health facilities","Health professions","Medicare","Reporting and recordkeeping requirements"],"type":"Proposed Rule","volume":85}