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 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