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:
Can I get an off-the-shelf back or knee brace from my doctor or hospital?
If you live in or are visiting a Competitive Bidding Area and your doctor or treating health care provider prescribes you an off-the-shelf back or knee brace, you generally must use a contract supplier if you want Medicare to help pay for the back or knee brace, unless you have an exception.
You may have one of these exceptions:
- Your doctor or treating health care provider (including physical therapists and occupational therapists) has the option to give you an off-the-shelf back or knee brace without being a contract supplier, if they give you the brace during your appointment as part of the clinical service.
- Your doctor or treating health care provider can supply an off-the-shelf back or knee brace while you're admitted to the hospital or on the day you’re discharged, even if your provider isn't a contract supplier.
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