You're affected by the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program if you live in (or are visiting) certain areas of the country and need an off-the-shelf back or knee brace.
What equipment & supplies are included?
- Off-the-shelf back braces
- Off-the-shelf knee braces
What areas of the country are included?
See below for a list of the areas included in the Round 2021 DMEPOS Competitive Bidding Program:
- Northeast
-
- Albany-Schenectady-Troy, NY
- Allentown-Bethlehem-Easton, PA
- Boston-Cambridge-Quincy, MA (only knee braces)
- Bridgeport-Stamford-Norwalk, CT
- Bristol County, MA (only knee braces)
- Bronx-Manhattan, NY
- Buffalo-Cheektowaga-Niagara Falls, NY
- Camden, NJ
- Elizabeth-Lakewood-New Brunswick, NJ
- Hartford-West Hartford-East Hartford, CT
- Jersey City-Newark, NJ (only back braces)
- Mercer County, PA
- Nassau, Kings, Queens & Richmond Counties, NY
- New Haven-Milford, CT
- Philadelphia, PA
- Pittsburgh, PA
- Port Chester-White Plains-Yonkers, NY (only knee braces)
- Poughkeepsie-Newburgh- Middletown, NY
- Providence, RI
- Rochester, NY
- Rockingham & Strafford Counties, NH
- Scranton--Wilkes-Barre--Hazleton, PA
- Springfield, MA
- Suffolk County, NY (only knee braces)
- Syracuse, NY
- Wilmington, DE
- Midwest
-
- Akron, OH
- Aurora-Elgin-Joliet, IL
- Chicago-Naperville-Arlington Heights, IL
- Cincinnati, OH
- Cleveland-Elyria, OH
- Columbus, OH
- Council Bluffs, IA
- Dayton, OH
- Dearborn, Franklin, Ohio, & Union Counties, IN
- Detroit-Warren-Dearborn, MI
- East St. Louis, IL
- Flint, MI
- Gary, IN
- Grand Rapids-Wyoming, MI
- Huntington, WV
- Indianapolis-Carmel-Anderson, IN
- Jeffersonville-New Albany, IN
- Kansas City, MO
- Kansas City-Overland Park-Ottawa, KS
- Kenosha County, WI
- Lake & McHenry Counties, IL
- Milwaukee-Waukesha-West Allis, WI
- Minneapolis-St. Paul-Bloomington, MN
- Omaha, NE
- Pierce & St. Croix Counties, WI
- St. Louis, MO
- Toledo, OH
- Wichita, KS
- Youngstown-Warren-Boardman, OH
- South
-
- Aiken & Edgefield Counties, SC
- Arlington-Alexandria-Reston, VA
- Asheville, NC
- Atlanta-Sandy Springs-Roswell, GA
- Augusta-Richmond County, GA
- Austin-Round Rock, TX
- Baltimore-Columbia-Towson, MD
- Baton Rouge, LA
- Beaumont-Port Arthur, TX
- Birmingham-Hoover, AL
- Calvert, Charles & Prince George's Counties, MD
- Cape Coral-Fort Myers, FL (only back braces)
- Catoosa, Dade & Walker Counties, GA
- Charleston-North Charleston, SC
- Charlotte-Concord-Gastonia, NC
- Chattanooga, TN (only knee braces)
- Chester, Lancaster & York Counties, SC
- Columbia, SC
- Covington-Florence-Newport, KY
- Dallas-Fort Worth-Arlington, TX
- Deltona-Daytona Beach-Ormond Beach, FL (only back braces)
- El Paso, TX
- Greensboro-High Point, NC
- Greenville-Anderson-Mauldin, SC
- Houston-The Woodlands-Sugar Land, TX
- Jackson, MS (only back braces)
- Jacksonville, FL
- Knoxville, TN
- Lakeland-Winter Haven, FL (only back braces)
- Little Rock-North Little Rock-Conway, AR (only knee braces)
- Louisville-Jefferson County, KY
- McAllen-Edinburg-Mission, TX
- Memphis, TN
- Nashville-Davidson-Murfreesboro-Franklin, TN
- New Orleans-Metairie, LA
- North Port-Sarasota-Bradenton, FL (only back braces)
- Ocala, FL
- Oklahoma City, OK
- Orlando-Kissimmee-Sanford, FL
- Palm Bay-Melbourne-Titusville, FL
- Raleigh, NC
- Richmond, VA
- San Antonio-New Braunfels, TX
- Silver Spring-Rockville-Bethesda, MD
- South Haven-Olive Branch, MS
- Tampa-St. Petersburg-Clearwater, FL
- Tulsa, OK
- Virginia Beach-Norfolk-Newport News, VA
- Washington, DC
- West
-
- Albuquerque, NM
- Bakersfield, CA
- Boise City, ID
- Denver-Aurora-Lakewood, CO (only knee braces)
- Fresno, CA
- Honolulu, HI (only back braces)
- Las Vegas-Henderson-Paradise, NV
- Los Angeles County, CA
- Orange County, CA
- Oxnard-Thousand Oaks-Ventura, CA
- Phoenix-Mesa-Scottsdale, AZ
- Portland-Hillsboro-Beaverton, OR
- Riverside-San Bernardino-Ontario, CA
- Sacramento-Roseville-Arden-Arcade, CA
- Salt Lake City, UT
- San Diego-Carlsbad, CA
- San Francisco-Oakland-Hayward, CA
- San Jose-Sunnyvale-Santa Clara, CA
- Seattle-Tacoma-Bellevue, WA (only knee braces)
- Stockton-Lodi, CA
- Tucson, AZ
- Vancouver, WA (only knee braces)
- Visalia-Porterville, CA
Can I get an off-the-shelf back or knee brace from my doctor or hospital?
If you live in or visit a competitive bidding area, you generally must get the off-the-shelf back or knee brace from a Medicare contract supplier for Medicare to pay. However, in certain cases, your doctor, physical or occupational therapist, or treating health care provider can sometimes supply an off-the-shelf back or knee brace in these situations:
- When you're getting other medical care, even if they aren't a Medicare contract supplier.
- If you're hospitalized and need one while you're admitted or on the day you're discharged from the hospital.
Visit the Medicare Supplier Directory to see if your ZIP code and the DMEPOS you need are included in the Competitive Bidding Program.
Can I use any supplier I want?
In most cases, if you have Original Medicare and live in or travel to a competitive bidding area, Medicare will only help pay for off-the-shelf back or knee braces if a contract supplier provides them. However, you may also get an off-the-shelf back or knee brace from your treating medical provider, or a hospital, as long as they’re enrolled as a supplier with Medicare.
More about the Competitive Bidding Program
Where can I get off-the-shelf back and knee braces when I travel?
How does Medicare's coverage of off-the-shelf back and knees braces work with other insurance?