Claims Submitted for Physicians and Treating Practitioners Who

50.7 - Claims Submitted for Physicians and Treating Practitioners Who Furnish Competitively Bid Items (Rev. 1544, Issued: 06-26-08, Effective: 07-01-08, Implementation: 07-07-08) Under DMEPOS Competitive Bidding, physicians and treating practitioners may furnish certain competitively bid items without submitting a bid and being awarded a contract. This exception requires that the items be furnished by the physician or treating practitioner to his or her own patients as part of his or her professional service. The professional service must be furnished on the same date as the date that the DME item is initially furnished. In addition, physicians and treating practitioners must submit their office visit claim on the same day that they submit the DME claim to ensure timely and accurate claims processing. Physicians and treating practitioners who provide DME items in their offices shall continue to be paid even though they are not a contract supplier for the items. See §20.6 for additional information. Physicians and treating practitioners that are located in a CBA must submit the “KV” modifier on claims for competitively bid items and related accessories that are furnished in accordance with this exception to receive payment for these items for the CBA where the beneficiary maintains a permanent residence. Physician and treating practitioner submitted competitive bidding claims that do not have an accompanying office visit will be denied. Physicians and treating practitioners located outside a CBA who furnish DME competitively bid items and/or related accessories as part of a professional service to traveling beneficiaries who maintain a permanent residence in a CBA must also affix the “KV” modifier to claims submitted for these items.