Process for Submitting Revisions to DMEPOS Fee Schedule to

60.4 - Process for Submitting Revisions to DMEPOS Fee Schedule to CMS (Rev. 12068; Issued: 06-02-23; Effective: 07-01-23; Implementation: 07-03-23) The DME MACs identify instances where revisions to DMEPOS fees are needed and forward requests to CMS via email to the Division of Data Systems. The information must be contained in an ASCII file. The requests must include a narrative description. The following file specifications are 2003 examples, the actual file names may change each year: Data Set Name DMEREV1A.TXT First Quarter Submission DMEREV1B.TXT Second Quarter Submission DMEREV1C.TXT Third Quarter Submission DMEREV1D.TXT Fourth Quarter Submission Record Format Field Name PIC Position Comment HCPCS Code X(5) 1 - 5 Filler X(1) 6 - 6 Set to Spaces First Modifier X(2) 7 - 8 Filler X(1) 9 Set to Spaces Second Modifier X(2) 10 - 11 Filler X(2) 12 - 13 Set to Spaces State X(3) 14 - 16 Filler X(1) 17 Set to Spaces Revised Base Fee S9(5)V99 18 - 26 1992 level for surgical dressings; 1995 level for PEN; 2013 level for Splints & Casts; 2012 level for certain IOLs; 1989 for all other categories Filler X(1) 27 Set to Spaces Capped Rental Rebasing Indicator X(1) 28 For Capped Rental Services Only: 0 - IR not applied to original base fee and base fee in effect prior to 1991, base fee is subject to rebasing adjustment 1 - IR applied to original base fee or base fee not in effect prior to 1991, base fee is exempted from rebasing adjustment Filler X(1) 29 Set to Spaces Field Name PIC Position Comment Nature of Fee Revision X(1) 30 0 = Correction 1 = IR Revision 2 = Other - Please submit supporting documentation. Filler X(1) 31 Set to Spaces IR - Effective Date 9(8) 32 - 39 Field is applicable only to those records where the fee has changed due to an inherent reasonableness decision and the previous field contains a value of “1.” Format is YYYYMMDD The CMS will recalculate current year fee schedule amounts as appropriate and release the entire file in the record layout described in §60.1. An indicator in the record field (Pricing Change Indicator) will identify those instances where pricing amounts have changed. The CMS will also issue instructions for implementing the revised fee schedule amounts with the fee schedule.