PDF Version
TO:
ALL DME PROVIDERS
RE:
2024 Durable Medical Equipment (DME) Cures Act Fee Schedule and Recoupments
Effective
May 1, 2018, the Alabama Medicaid Agency (Medicaid) implemented the Durable
Medical Equipment (DME) fee schedule that meets the requirements of 21st
Century Cures Act.
The
law requires Medicaid to be responsible for expenditures that exceed the
aggregate limit for any DME items detailed in section 1861(n) of the Social
Security Act on or after January 1, 2018. Alabama is liable for any federal
portion that exceeds these aggregate limits. Due to this change, it is
necessary for Medicaid to implement the CMS Medicare rates for the affected DME
codes. The updated rates affect the specific codes identified by CMS, and Medicaid
will update the DME fee schedule on its website accordingly. The list of codes
and rates are updated annually in accordance with CMS annual updates.
As
a result of the January 1, 2024 Cures Act fee schedule update:
- The published Fee Schedule has been
updated to reflect the updated CURES Act rates on the Medicaid website at https://medicaid.alabama.gov/content/Gated/7.3G_Fee_Schedules.aspx
- Claim adjustments will occur during the
July 19, August 2, August 16, and August 30, 2024 checkwrites for claims
that resulted in an overpayment or underpayment to providers due to the
CURES rate update.
- Recouped claims will be listed on the remittance
advice under adjustments.
Questions related
to the upcoming adjustments can be directed to the DME Program Manager, Jessica
Grace, at (334) 242-2326 or jessica.grace@medicaid.alabama.gov.
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