No. The DMEPOS CBP requirements apply irrespective of who owns a DME company and do not exempt any suppliers in a competitive bidding area from a competitive bidding program.
There are situations where specific types of competitive bidding items may be furnished by a hospital, physician, treating practitioner, physical therapist, or occupational therapist who is not awarded contracts under the CBP. The hospital, physician, treating practitioner, physical therapist, or occupational therapist doesn’t have to be a contract supplier in these cases, and CMS pays for the item based on the applicable single payment amount.
These situations are as follows:
Physicians, treating practitioners, and hospitals may furnish certain types of competitively bid DME without submitting a bid and being awarded a contract under the CBP if all of these apply:
- The furnished items are limited to crutches, canes, walkers, folding manual wheelchairs, blood glucose monitors, infusion pumps that are DME, and off-the-shelf (OTS) orthotics;
- The physician or treating practitioner furnishes the items to their own patients as part of their professional service or the hospital furnishes the items to its own patients during an admission or on the date of discharge; and
- The items are billed under a billing number assigned to the hospital, physician, the treating practitioner (if possible), or a group practice to which the physician or treating practitioner has reassigned the right to get Medicare payment.
A physical therapist in private practice (as defined in 42 CFR § 410.60(c)) or an occupational therapist in private practice (as defined in 42 CFR § 410.59(c)) may furnish competitively bid OTS orthotics without submitting a bid and being awarded a contract under the CBP, if the therapist furnishes the items to their own patients as part of the physical or occupational therapy service.
For more information on these exceptions, visit 42 CFR § 414.404(b).