Medicare Claims Processing Manual (Pub. 100-04), Ch. 36 § 40.3.3

Accessories and Supplies for Grandfathered Items

Last amended: 2008Year: 2008Length: 137 wordsOfficial source
40.3.3 - Accessories and Supplies for Grandfathered Items (Rev. 1502; Issued: 05-09-08; Effective/Implementation Date: 06-09-08) Accessories and supplies that are used in conjunction with and are necessary for the effective use of a grandfathered item may be furnished by the same grandfathered supplier that furnishes the grandfathered item. Examples of medically necessary accessories and supplies used in conjunction with DMEPOS items include tubes, hoses, and masks with respiratory equipment and administration sets with infusion pumps. Payment for these items to a grandfathered supplier is based on the single payment amount if the item is a competitive bid item for the CBA in which the beneficiary maintains a permanent residence (see §36.40.1 of chapter 20 in this manual). If the item is not a competitive bidding item, payment will be made in accordance with the standard payment rules.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 36 § 40.3.3: Accessories and Supplies for Grandfathered Items | Justis AI