Prescribing new equipment
The prescribing, medical necessity, and coverage rules have not changed under Medicare competitive bidding. Therefore, you will prescribe equipment for your patient the same way you always have. If you have questions about coverage you can direct them to Medicare or a local contracted supplier.
What has changed under Medicare competitive bidding is where your prescription can be sent to be filled. Inclusion in this program is determined by your patient's home zip code that is on file with the Social Security Administration. You can determine if your patient is included in this program by using our search tool on the homepage.
The search feature will tell you if the ZIP code is included in the Medicare competitive bidding program. It will also provide a list of contracted companies that can fill your order.
It should be noted that Medicare competitive bidding program includes nine product categories. These categories consist of the most commonly prescribed DME items. If the product you are prescribing is not included in one of these categories but the patient resides in a Medicare competitive bidding area the order may be sent to any provider. If the product is included in one of the categories it must be sent to a contracted supplier.
What you need to know about sub-contracting under the Medicare Competitive Bidding program.
Best practices for finding and utilizing sub-contractors to grow your business.