CMS released a fact sheet on November 28, 2025 stating each DMEPOS CBP product category in the next round of competitive bidding will be included in a remote item delivery (RID) competitive bidding program (CBP) under a nationwide competitive bidding area (CBA) (Nationwide RID CBP). Per 42 CFR § 414.416(b)(1), the single payment amount for a lead item furnished under a CBP is equal to the 75th percentile of bid amounts submitted for that item by suppliers whose composite bids for the product category that includes the item are equal to or below the pivotal bid for that product category. Per 42 CFR § 414.416(b)(3), the single payment amount for an item in a product category in a RID CBP that is not a lead item for that product category (non-lead item) is equal to the single payment amount for the lead item in the same product category multiplied by the ratio of the average 2015 fee schedule amount for the non-lead item for the applicable area to which the fee schedule amount applies (State, District of Columbia, Puerto Rico, or United States Virgin Islands, a combination thereof, or nationwide) to the average 2015 fee schedule amount for the lead item for the same area.
To determine the average 2015 fee schedule amounts for the ratios, CMS will use the fee schedule amounts used to pay for the catheters in 2015. The fee schedule amounts for the HCPCS Level II urinary catheter codes that became effective January 1, 2026 (A4295, A4296, A4297) were cross-walked to the HCPCS Level II urinary catheter codes (A4351, A4352, A4353) that were in effect in 2015. More information about the payment determinations for these new HCPCS Level II codes can be found in CMS’s HCPCS Level II final Coding, Benefit Category and Payment Determinations, First Biannual (B1), 2024 HCPCS Coding Cycle (https://www.cms.gov/files/document/2024-hcpcs-application-summary-biannual-1-2024-non-drug-and-non-biological-items-and-services.pdf).