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 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
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?
