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Deadline For Comments Regarding TRICARE's Proposed DMEPOS And PEN Item Reimbursement

As announced in December 2020, TRICARE is proposing a change to how they reimburse for DMEPOS and PEN (DME, O&P, and Enteral Nutrition) items that do not have specific reimbursement rates on the Medicare fee schedule. They have created a TRICARE-specific fee schedule for these otherwise unlisted/unpriced items, and that additional fee schedule is set to be implemented effective July 1, 2021.

TRICARE is accepting comments until January 28, 2021. If you feel you would be impacted by this change (i.e. you treat TRICARE members, and you bill for DMEPOS and/or PEN products and services that do not have a traditional Medicare allowable), you will want to review the proposed changes and the new fee schedule here: https://www.federalregister.gov/documents/2020/12/29/2020-28762/tricare-proposed-rates-for-reimbursing-durable-medical-equipment-prosthetics-orthotics-and-supplies.

After reviewing the proposed changes, if you have not yet done so, you can submit comments any time between now and Thursday of this week by following the instructions found on that page.