DMEPOS Competitive Bidding – Round 1 Rebid
Product Categories and HCPCS Codes
Product Category: Oxygen Supplies and Equipment
2
Product Category: Standard Power Wheelchairs, Scooters
and Related Accessories
3
Product Category: Complex Rehabilitative Power Wheelchairs,
and Related Accessories (Group 2)
6
Product Category: Mail-Order Diabetic Supplies*
10
Product Category: Enteral Nutrients, Equipment and Supplies
11
Product Category: CPAP Devices, Respiratory Assist Devices
and Related Supplies and Accessories
12
Product Category: Hospital Beds and Related Accessories
13
Product Category: Walkers and Related Accessories
14
Product Category: Support Surfaces (Group 2 mattresses
and overlays) in Miami - Fort Lauderdale - Pompano Beach,
Florida
15
* The Round 1 Rebid contracts for mail-order diabetic supplies ended on December 31, 2012, so information about the Round
1 Rebid mail-order diabetic supplies product category no longer applies.
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Oxygen Supplies and Equipment
Payment Class
HCPCS
Code
HCPCS Code Description
Payment Class A - Stationary Oxygen Equipment &
Oxygen Contents (Stationary & Portable)
E1390
Oxygen Concentrator, Single Delivery Port, Capable Of Delivering 85 Percent Or Greater Oxygen
Concentration At The Prescribed Flow Rate - Bid For Entire Class Using This Code
Payment Class A - Stationary Oxygen Equipment &
Oxygen Contents (Stationary & Portable)
E0424
Stationary Compressed Gaseous Oxygen System, Rental; Includes Container, Contents, Regulator,
Flowmeter, Humidifier, Nebulizer, Cannula Or Mask, And Tubing - Bid For Entire Class; Not By Code
Payment Class A - Stationary Oxygen Equipment &
Oxygen Contents (Stationary & Portable)
E0439
Stationary Liquid Oxygen System, Rental; Includes Container, Contents, Regulator, Flowmeter,
Humidifier, Nebulizer, Cannula Or Mask, & Tubing - Bid For Entire Class; Not By Code
Payment Class A - Stationary Oxygen Equipment &
Oxygen Contents (Stationary & Portable)
E1391
Oxygen Concentrator, Dual Delivery Port, Capable Of Delivering 85 Percent Or Greater Oxygen
Concentration At The Prescribed Flow Rate, Each - Bid For Entire Class; Not By Code
Payment Class B - Portable Equipment Only (Gaseous or
Liquid Tanks)
E0431
Portable Gaseous Oxygen System, Rental; Includes Portable Container, Regulator, Flowmeter,
Humidifier, Cannula Or Mask, And Tubing - Bid For Entire Class Using This Code
Payment Class B - Portable Equipment Only (Gaseous or
Liquid Tanks)
E0434
Portable Liquid Oxygen System, Rental; Includes Portable Container, Supply Reservoir, Humidifier,
Flowmeter, Refill Adaptor, Contents Gauge, Cannula Or Mask, And Tubing - Bid For Entire Class;
Not By Code
Payment Class C - Oxygen Generating Portable Equipment
Only
E1392
Portable Oxygen Concentrator, Rental - Bid For Entire Class Using This Code
Payment Class C - Oxygen Generating Portable Equipment
Only
K0738
Portable Gaseous Oxygen System, Rental; Home Compressor Used To Fill Portable Oxygen
Cylinders; Includes Portable Containers, Regulator, Flowmeter, Humidifier, Cannula Or Mask, And
Tubing - Bid For Entire Class; Not By Code
Payment Class D - Stationary Oxygen Contents Only
E0441
Oxygen Contents, Gaseous (For Use With Owned Gaseous Stationary Systems Or When Both A
Stationary And Portable Gaseous System Are Owned), 1 Month's Supply = 1 Unit - Bid For Entire
Class Using This Code
Payment Class D - Stationary Oxygen Contents Only
E0442
Oxygen Contents, Liquid (For Use With Owned Liquid Stationary Systems Or When Both A
Stationary And Portable Liquid System Are Owned), 1 Month's Supply = 1 Unit - Bid For Entire
Class; Not By Code
Payment Class E - Portable Oxygen Contents Only
E0443
Portable Oxygen Contents, Gaseous (For Use Only With Portable Gaseous Systems When No
Stationary Gas Or Liquid System Is Used), 1 Month's Supply = 1 Unit - Bid For Entire Class Using
This Code
Payment Class E - Portable Oxygen Contents Only
E0444
Portable Oxygen Contents, Liquid (For Use Only With Portable Liquid Systems When No Stationary
Gas Or Liquid System Is Used), 1 Month's Supply = 1 Unit - Bid For Entire Class; Not By Code
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Standard Power Wheelchairs, Scooters, and Related Accessories
HCPCS
Code
K0823
K0800
K0822
K0825
K0801
K0814
K0824
K0821
K0816
K0827
K0806
K0813
K0815
K0826
K0828
K0802
K0807
K0829
K0820
K0808
E2365
E0973
E2361
E2363
E0990
E2601
E2386
E0978
E2392
E0951
E2366
E2370
E2611
K0019
E2387
E2381
HCPCS Code Description
Power Wheelchair, Group 2 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Power Operated Vehicle, Group 1 Standard, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Standard, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Heavy Duty, Captains Chair, Patient Weight Capacity 301 To 450 Pounds
Power Operated Vehicle, Group 1 Heavy Duty, Patient Weight Capacity 301 To 450 Pounds
Power Wheelchair, Group 1 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds
Power Wheelchair, Group 2 Standard, Portable, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 1 Standard, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Very Heavy Duty, Captains Chair, Patient Weight Capacity 451 To 600 Pounds
Power Operated Vehicle, Group 2 Standard, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 1 Standard, Portable, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 1 Standard, Sling/Solid Seat And Back, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Very Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds
Power Wheelchair, Group 2 Extra Heavy Duty, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More
Power Operated Vehicle, Group 1 Very Heavy Duty, Patient Weight Capacity 451 To 600 Pounds
Power Operated Vehicle, Group 2 Heavy Duty, Patient Weight Capacity 301 To 450 Pounds
Power Wheelchair, Group 2 Extra Heavy Duty, Captains Chair, Patient Weight 601 Pounds Or More
Power Wheelchair, Group 2 Standard, Portable, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Power Operated Vehicle, Group 2 Very Heavy Duty, Patient Weight Capacity 451 To 600 Pounds
Power Wheelchair Accessory, U-1 Sealed Lead Acid Battery, Each (E.G. Gel Cell, Absorbed Glassmat)
Wheelchair Accessory, Adjustable Height, Detachable Armrest, Complete Assembly, Each
Power Wheelchair Accessory, 22nf Sealed Lead Acid Battery, Each, (E.G. Gel Cell, Absorbed Glassmat)
Power Wheelchair Accessory, Group 24 Sealed Lead Acid Battery, Each (E.G. Gel Cell, Absorbed Glassmat)
Wheelchair Accessory, Elevating Leg Rest, Complete Assembly, Each
General Use Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Power Wheelchair Accessory, Foam Filled Drive Wheel Tire, Any Size, Replacement Only, Each
Wheelchair Accessory, Positioning Belt/Safety Belt/Pelvic Strap, Each
Power Wheelchair Accessory, Solid (Rubber/Plastic) Caster Tire With Integrated Wheel, Any Size, Replacement Only, Each
Heel Loop/Holder, Any Type, With Or Without Ankle Strap, Each
Power Wheelchair Accessory, Battery Charger, Single Mode, For Use With Only One Battery Type, Sealed Or Non-Sealed, Each
Power Wheelchair Component, Motor And Gear Box Combination, Replacement Only
General Use Wheelchair Back Cushion, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
Arm Pad, Each
Power Wheelchair Accessory, Foam Filled Caster Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each
HCPCS
Code
HCPCS Code Description
E1028
Wheelchair Accessory, Manual Swingaway, Retractable Or Removable Mounting Hardware For Joystick, Other Control Interface Or Positioning Accessory
E2208
E2394
E2384
K0733
E2391
E2382
E2383
E2395
E2210
K0040
E0955
E2603
E2622
E2396
E0956
E2607
E2368
E2385
E2602
E2209
E2390
E2615
E2624
E2605
E1016
E2389
E1020
Wheelchair Accessory, Cylinder Tank Carrier, Each
Power Wheelchair Accessory, Drive Wheel Excludes Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Pneumatic Caster Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, 12 To 24 Amp Hour Sealed Lead Acid Battery, Each (E.G., Gel Cell, Absorbed Glassmat)
Power Wheelchair Accessory, Solid (Rubber/Plastic) Caster Tire (Removable), Any Size, Replacement Only, Each
Power Wheelchair Accessory, Tube For Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Insert For Pneumatic Drive Wheel Tire (Removable), Any Type, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Caster Wheel Excludes Tire, Any Size, Replacement Only, Each
Wheelchair Accessory, Bearings, Any Type, Replacement Only, Each
Adjustable Angle Footplate, Each
Wheelchair Accessory, Headrest, Cushioned, Any Type, Including Fixed Mounting Hardware, Each
Skin Protection Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Skin Protection Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth
Power Wheelchair Accessory, Caster Fork, Any Size, Replacement Only, Each
Wheelchair Accessory, Lateral Trunk Or Hip Support, Any Type, Including Fixed Mounting Hardware, Each
Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Power Wheelchair Component, Motor, Replacement Only
Power Wheelchair Accessory, Tube For Pneumatic Caster Tire, Any Size, Replacement Only, Each
General Use Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
Accessory, Arm Trough, With Or Without Hand Support, Each
Power Wheelchair Accessory, Solid (Rubber/Plastic) Drive Wheel Tire, Any Size, Replacement Only, Each
Positioning Wheelchair Back Cushion, Posterior-Lateral, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
Skin Protection And Positioning Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth
Positioning Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Shock Absorber For Power Wheelchair, Each
Power Wheelchair Accessory, Foam Caster Tire, Any Size, Replacement Only, Each
Residual Limb Support System For Wheelchair
E2620
Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
E0950
E0960
K0052
E2388
K0053
E0981
E2619
K0038
E2613
E2371
Wheelchair Accessory, Tray, Each
Wheelchair Accessory, Shoulder Harness/Straps Or Chest Strap, Including Any Type Mounting Hardware
Swingaway, Detachable Footrests, Each
Power Wheelchair Accessory, Foam Drive Wheel Tire, Any Size, Replacement Only, Each
Elevating Footrests, Articulating (Telescoping), Each
Wheelchair Accessory, Seat Upholstery, Replacement Only, Each
Replacement Cover For Wheelchair Seat Cushion Or Back Cushion, Each
Leg Strap, Each
Positioning Wheelchair Back Cushion, Posterior, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
Power Wheelchair Accessory, Group 27 Sealed Lead Acid Battery, (E.G. Gel Cell, Absorbed Glassmat), Each
HCPCS
Code
HCPCS Code Description
E0982
E2367
K0043
E0957
E2369
K0017
K0015
K0045
E0952
K0018
K0044
E0995
K0047
K0041
E2604
E2612
K0051
E2623
K0020
K0042
K0039
E2608
E2606
K0046
E2625
K0098
K0037
Wheelchair Accessory, Back Upholstery, Replacement Only, Each
Power Wheelchair Accessory, Battery Charger, Dual Mode, For Use With Either Battery Type, Sealed Or Non-Sealed, Each
Footrest, Lower Extension Tube, Each
Wheelchair Accessory, Medial Thigh Support, Any Type, Including Fixed Mounting Hardware, Each
Power Wheelchair Component, Gear Box, Replacement Only
Detachable, Adjustable Height Armrest, Base, Each
Detachable, Non-Adjustable Height Armrest, Each
Footrest, Complete Assembly
Toe Loop/Holder, Any Type, Each
Detachable, Adjustable Height Armrest, Upper Portion, Each
Footrest, Upper Hanger Bracket, Each
Wheelchair Accessory, Calf Rest/Pad, Each
Elevating Legrest, Upper Hanger Bracket, Each
Large Size Footplate, Each
Skin Protection Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
General Use Wheelchair Back Cushion, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
Cam Release Assembly, Footrest Or Legrest, Each
Skin Protection Wheelchair Seat Cushion, Adjustable, Width 22 Inches Or Greater, Any Depth
Fixed, Adjustable Height Armrest, Pair
Standard Size Footplate, Each
Leg Strap, H Style, Each
Skin Protection And Positioning Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
Positioning Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
Elevating Legrest, Lower Extension Tube, Each
Skin Protection And Positioning Wheelchair Seat Cushion, Adjustable, Width 22 Inches Or Greater, Any Depth
Drive Belt For Power Wheelchair
High Mount Flip-Up Footrest, Each
E2621
Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
E2616
E2614
K0050
Positioning Wheelchair Back Cushion, Posterior-Lateral, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
Positioning Wheelchair Back Cushion, Posterior, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
Ratchet Assembly
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Complex Rehabilitative Power Wheelchairs and Related Accessories (Group 2)
HCPCS
Code
K0835
K0836
K0843
K0841
K0838
K0842
K0837
K0839
K0840
E2365
E2375
E0973
E2377
E2361
E1002
E2374
E2363
E2311
E0990
E1007
E2310
E2601
E1010
E2321
E2376
E2386
E2323
E0978
E2392
E0951
E2366
E2370
E2611
K0019
E2387
HCPCS Code Description
Power Wheelchair, Group 2 Standard, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Standard, Single Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Heavy Duty, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds
Power Wheelchair, Group 2 Standard, Multiple Power Option, Sling/Solid Seat/Back, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Heavy Duty, Single Power Option, Captains Chair, Patient Weight Capacity 301 To 450 Pounds
Power Wheelchair, Group 2 Standard, Multiple Power Option, Captains Chair, Patient Weight Capacity Up To And Including 300 Pounds
Power Wheelchair, Group 2 Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 301 To 450 Pounds
Power Wheelchair, Group 2 Very Heavy Duty, Single Power Option Sling/Solid Seat/Back, Patient Weight Capacity 451 To 600 Pounds
Power Wheelchair, Group 2 Extra Heavy Duty, Single Power Option, Sling/Solid Seat/Back, Patient Weight Capacity 601 Pounds Or More
Power Wheelchair Accessory, U-1 Sealed Lead Acid Battery, Each (E.G. Gel Cell, Absorbed Glassmat)
Power Wheelchair Accessory, Non-Expandable Controller, Including All Related Electronics And Mounting Hardware, Replacement Only
Wheelchair Accessory, Adjustable Height, Detachable Armrest, Complete Assembly, Each
Power Wheelchair Accessory, Expandable Controller, Including All Related Electronics And Mounting Hardware, Upgrade Provided At Initial Issue
Power Wheelchair Accessory, 22nf Sealed Lead Acid Battery, Each, (E.G. Gel Cell, Absorbed Glassmat)
Wheelchair Accessory, Power Seating System, Tilt Only
Power Wheelchair Accessory, Hand Or Chin Control Interface, Standard Remote Joystick (Not Including Controller), Proportional, Including All Related
Electronics And Fixed Mounting Hardware, Replacement Only
Power Wheelchair Accessory, Group 24 Sealed Lead Acid Battery, Each (E.G. Gel Cell, Absorbed Glassmat)
Power Wheelchair Accessory, Electronic Connection Between Wheelchair Controller And Two Or More Power Seating System Motors, Including All Related
Electronics, Indicator Feature, Mechanical Function Selection Switch, And Fixed Mounting Hardware
Wheelchair Accessory, Elevating Leg Rest, Complete Assembly, Each
Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Mechanical Shear Reduction
Power Wheelchair Accessory, Electronic Connection Between Wheelchair Controller And One Power Seating System Motor, Including All Related Electronics,
Indicator Feature, Mechanical Function Selection Switch, And Fixed Mounting Hardware
General Use Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Wheelchair Accessory, Addition To Power Seating System, Power Leg Elevation System, Including Leg Rest, Pair
Power Wheelchair Accessory, Hand Control Interface, Remote Joystick, Nonproportional, Including All Related Electronics, Mechanical Stop Switch, And Fixed
Mounting Hardware
Power Wheelchair Accessory, Expandable Controller, Including All Related Electronics And Mounting Hardware, Replacement Only
Power Wheelchair Accessory, Foam Filled Drive Wheel Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Specialty Joystick Handle For Hand Control Interface, Prefabricated
Wheelchair Accessory, Positioning Belt/Safety Belt/Pelvic Strap, Each
Power Wheelchair Accessory, Solid (Rubber/Plastic) Caster Tire With Integrated Wheel, Any Size, Replacement Only, Each
Heel Loop/Holder, Any Type, With Or Without Ankle Strap, Each
Power Wheelchair Accessory, Battery Charger, Single Mode, For Use With Only One Battery Type, Sealed Or Non-Sealed, Each
Power Wheelchair Component, Motor And Gear Box Combination, Replacement Only
General Use Wheelchair Back Cushion, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
Arm Pad, Each
Power Wheelchair Accessory, Foam Filled Caster Tire, Any Size, Replacement Only, Each
HCPCS
Code
HCPCS Code Description
E2381
Power Wheelchair Accessory, Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each
E1028
Wheelchair Accessory, Manual Swingaway, Retractable Or Removable Mounting Hardware For Joystick, Other Control Interface Or Positioning Accessory
E2208
E2394
E2384
K0733
E2391
E2382
E2383
E2395
E2210
K0040
E0955
E2603
E1020
Wheelchair Accessory, Cylinder Tank Carrier, Each
Power Wheelchair Accessory, Drive Wheel Excludes Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Pneumatic Caster Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, 12 To 24 Amp Hour Sealed Lead Acid Battery, Each (E.G., Gel Cell, Absorbed Glassmat)
Power Wheelchair Accessory, Solid (Rubber/Plastic) Caster Tire (Removable), Any Size, Replacement Only, Each
Power Wheelchair Accessory, Tube For Pneumatic Drive Wheel Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Insert For Pneumatic Drive Wheel Tire (Removable), Any Type, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Caster Wheel Excludes Tire, Any Size, Replacement Only, Each
Wheelchair Accessory, Bearings, Any Type, Replacement Only, Each
Adjustable Angle Footplate, Each
Wheelchair Accessory, Headrest, Cushioned, Any Type, Including Fixed Mounting Hardware, Each
Skin Protection Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Power Wheelchair Accessory, Hand Or Chin Control Interface, Compact Remote Joystick, Proportional, Including Fixed Mounting Hardware : Replacement Of
Special Power Wheelchair Interface
Skin Protection Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth
Power Wheelchair Accessory, Caster Fork, Any Size, Replacement Only, Each
Wheelchair Accessory, Lateral Trunk Or Hip Support, Any Type, Including Fixed Mounting Hardware, Each
Power Wheelchair Accessory, Hand Control Interface, Multiple Mechanical Switches, Nonproportional, Including All Related Electronics, Mechanical Stop Switch,
And Fixed Mounting Hardware
Skin Protection And Positioning Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, With Power Shear Reduction
Power Wheelchair Component, Motor, Replacement Only
Power Wheelchair Accessory, Head Control Interface, Proximity Switch Mechanism, Nonproportional, Including All Related Electronics, Mechanical Stop Switch,
Mechanical Direction Change Switch, Head Array, And Fixed Mounting Hardware
Power Wheelchair Accessory, Tube For Pneumatic Caster Tire, Any Size, Replacement Only, Each
Wheelchair Accessory, Power Seating System, Recline Only, With Mechanical Shear Reduction
General Use Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
Wheelchair Accessory, Ventilator Tray, Gimbaled
Accessory, Arm Trough, With Or Without Hand Support, Each
Power Wheelchair Accessory, Solid (Rubber/Plastic) Drive Wheel Tire, Any Size, Replacement Only, Each
Positioning Wheelchair Back Cushion, Posterior-Lateral, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
Skin Protection And Positioning Wheelchair Seat Cushion, Adjustable, Width Less Than 22 Inches, Any Depth
Positioning Wheelchair Seat Cushion, Width Less Than 22 Inches, Any Depth
Shock Absorber For Power Wheelchair, Each
Power Wheelchair Accessory, Foam Caster Tire, Any Size, Replacement Only, Each
Power Wheelchair Accessory, Sip And Puff Interface, Nonproportional, Including All Related Electronics, Mechanical Stop Switch, And Manual Swingaway
Mounting Hardware
Residual Limb Support System For Wheelchair
E2620
Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
E2373KC
E2622
E2396
E0956
E2322
E2607
E1008
E2368
E2330
E2385
E1004
E2602
E1030
E2209
E2390
E2615
E2624
E2605
E1016
E2389
E2325
HCPCS
Code
E1029
E2326
E0950
E0960
K0052
E2328
E2388
K0053
E1005
E0981
E2619
K0038
E2327
E2613
E2324
E2371
E0982
E2367
K0043
E1006
E0957
E2369
K0017
K0015
E1003
K0045
E2351
E0952
K0018
K0044
E0995
K0047
K0041
E2604
E2612
K0051
E2623
K0020
K0042
E2329
HCPCS Code Description
Wheelchair Accessory, Ventilator Tray, Fixed
Power Wheelchair Accessory, Breath Tube Kit For Sip And Puff Interface
Wheelchair Accessory, Tray, Each
Wheelchair Accessory, Shoulder Harness/Straps Or Chest Strap, Including Any Type Mounting Hardware
Swingaway, Detachable Footrests, Each
Power Wheelchair Accessory, Head Control Or Extremity Control Interface, Electronic, Proportional, Including All Related Electronics And Fixed Mounting
Hardware
Power Wheelchair Accessory, Foam Drive Wheel Tire, Any Size, Replacement Only, Each
Elevating Footrests, Articulating (Telescoping), Each
Wheelchair Accessory, Power Seatng System, Recline Only, With Power Shear Reduction
Wheelchair Accessory, Seat Upholstery, Replacement Only, Each
Replacement Cover For Wheelchair Seat Cushion Or Back Cushion, Each
Leg Strap, Each
Power Wheelchair Accessory, Head Control Interface, Mechanical, Proportional, Including All Related Electronics, Mechanical Direction Change Switch, And
Fixed Mounting Hardware
Positioning Wheelchair Back Cushion, Posterior, Width Less Than 22 Inches, Any Height, Including Any Type Mounting Hardware
Power Wheelchair Accessory, Chin Cup For Chin Control Interface
Power Wheelchair Accessory, Group 27 Sealed Lead Acid Battery, (E.G. Gel Cell, Absorbed Glassmat), Each
Wheelchair Accessory, Back Upholstery, Replacement Only, Each
Power Wheelchair Accessory, Battery Charger, Dual Mode, For Use With Either Battery Type, Sealed Or Non-Sealed, Each
Footrest, Lower Extension Tube, Each
Wheelchair Accessory, Power Seating System, Combination Tilt And Recline, Without Shear Reduction
Wheelchair Accessory, Medial Thigh Support, Any Type, Including Fixed Mounting Hardware, Each
Power Wheelchair Component, Gear Box, Replacement Only
Detachable, Adjustable Height Armrest, Base, Each
Detachable, Non-Adjustable Height Armrest, Each
Wheelchair Accessory, Power Seating System, Recline Only, Without Shear Reduction
Footrest, Complete Assembly
Power Wheelchair Accessory, Electronic Interface To Operate Speech Generating Device Using Power Wheelchair Control Interface
Toe Loop/Holder, Any Type, Each
Detachable, Adjustable Height Armrest, Upper Portion, Each
Footrest, Upper Hanger Bracket, Each
Wheelchair Accessory, Calf Rest/Pad, Each
Elevating Legrest, Upper Hanger Bracket, Each
Large Size Footplate, Each
Skin Protection Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
General Use Wheelchair Back Cushion, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
Cam Release Assembly, Footrest Or Legrest, Each
Skin Protection Wheelchair Seat Cushion, Adjustable, Width 22 Inches Or Greater, Any Depth
Fixed, Adjustable Height Armrest, Pair
Standard Size Footplate, Each
Power Wheelchair Accessory, Head Control Interface, Contact Switch Mechanism, Nonproportional, Including All Related Electronics, Mechanical Stop Switch,
Mechanical Direction Change Switch, Head Array, And Fixed Mounting Hardware
HCPCS
Code
HCPCS Code Description
K0039
E2608
E2606
K0046
E2625
K0098
K0037
Leg Strap, H Style, Each
Skin Protection And Positioning Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
Positioning Wheelchair Seat Cushion, Width 22 Inches Or Greater, Any Depth
Elevating Legrest, Lower Extension Tube, Each
Skin Protection And Positioning Wheelchair Seat Cushion, Adjustable, Width 22 Inches Or Greater, Any Depth
Drive Belt For Power Wheelchair
High Mount Flip-Up Footrest, Each
E2621
Positioning Wheelchair Back Cushion, Planar Back With Lateral Supports, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
E2616
E2614
K0050
Positioning Wheelchair Back Cushion, Posterior-Lateral, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
Positioning Wheelchair Back Cushion, Posterior, Width 22 Inches Or Greater, Any Height, Including Any Type Mounting Hardware
Ratchet Assembly
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Mail-Order Diabetic Supplies
HCPCS
Code
HCPCS Code Description
A4253KL
A4259KL
A4256KL
A4258KL
Blood Glucose Test Or Reagent Strips For Home Blood Glucose Monitor, Per 50 Strips : Dmepos Item Delivered Via Mail
Lancets, Per Box Of 100 : Dmepos Item Delivered Via Mail
Normal, Low And High Calibrator Solution / Chips : Dmepos Item Delivered Via Mail
Spring-Powered Device For Lancet, Each : Dmepos Item Delivered Via Mail
A4235KL
Replacement Battery, Lithium, For Use With Medically Necessary Home Blood Glucose Monitor Owned By Patient, Each : Dmepos Item Delivered Via Mail
A4233KL
A4234KL
A4236KL
Replacement Battery, Alkaline (Other Than J Cell), For Use With Medically Necessary Home Blood Glucose Monitor Owned By Patient, Each : Dmepos Item
Delivered Via Mail
Replacement Battery, Alkaline, J Cell, For Use With Medically Necessary Home Blood Glucose Monitor Owned By Patient, Each : Dmepos Item Delivered Via
Mail
Replacement Battery, Silver Oxide, For Use With Medically Necessary Home Blood Glucose Monitor Owned By Patient, Each : Dmepos Item Delivered Via Mail
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Enteral Nutrients, Equipment and Supplies
HCPCS
Code
B4150
B4152
B4154
B4035
B4153
B4034
B4155
B4036
B4149
E0776BA
B4087
B9002
B4088
B4082
B4083
B4081
B9000
HCPCS Code Description
Enteral Formula, Nutritionally Complete With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include Fiber, Administered
Through An Enteral Feeding Tube, 100 Calories = 1 Unit
Enteral Formula, Nutritionally Complete, Calorically Dense (Equal To Or Greater Than 1.5 Kcal/Ml) With Intact Nutrients, Includes Proteins, Fats, Carbohydrates,
Vitamins And Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit
Enteral Formula, Nutritionally Complete, For Special Metabolic Needs, Excludes Inherited Disease Of Metabolism, Includes Altered Composition Of Proteins,
Fats, Carbohydrates, Vitamins And/Or Minerals, May Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit
Enteral Feeding Supply Kit; Pump Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape
Enteral Formula, Nutritionally Complete, Hydrolyzed Proteins (Amino Acids And Peptide Chain), Includes Fats, Carbohydrates, Vitamins And Minerals, May
Include Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit
Enteral Feeding Supply Kit; Syringe Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape
Enteral Formula, Nutritionally Incomplete/Modular Nutrients, Includes Specific Nutrients, Carbohydrates (E.G. Glucose Polymers), Proteins/Amino Acids (E.G.
Glutamine, Arginine), Fat (E.G. Medium Chain Triglycerides) Or Combination, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit
Enteral Feeding Supply Kit; Gravity Fed, Per Day, Includes But Not Limited To Feeding/Flushing Syringe, Administration Set Tubing, Dressings, Tape
Enteral Formula, Manufactured Blenderized Natural Foods With Intact Nutrients, Includes Proteins, Fats, Carbohydrates, Vitamins And Minerals, May Include
Fiber, Administered Through An Enteral Feeding Tube, 100 Calories = 1 Unit
Iv Pole : Item Furnished In Conjunction With Parenteral Enteral Nutrition (Pen) Services
Gastrostomy/Jejunostomy Tube, Standard, Any Material, Any Type, Each
Enteral Nutrition Infusion Pump - With Alarm
Gastrostomy/Jejunostomy Tube, Low-Profile, Any Material, Any Type, Each
Nasogastric Tubing Without Stylet
Stomach Tube - Levine Type
Nasogastric Tubing With Stylet
Enteral Nutrition Infusion Pump - Without Alarm
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: CPAP Devices, Respiratory Assist Devices, and Related Supplies and Accessories
HCPCS
Code
A7038
A7037
A7035
A7034
A7032
A7033
A7039
A7030
E0562
E0601
A7031
A7046
A7036
E0470
A4604
E0471
E0561
A7045
A7044
E0472
HCPCS Code Description
Filter, Disposable, Used With Positive Airway Pressure Device
Tubing Used With Positive Airway Pressure Device
Headgear Used With Positive Airway Pressure Device
Nasal Interface (Mask Or Cannula Type) Used With Positive Airway Pressure Device, With Or Without Head Strap
Cushion For Use On Nasal Mask Interface, Replacement Only, Each
Pillow For Use On Nasal Cannula Type Interface, Replacement Only, Pair
Filter, Non Disposable, Used With Positive Airway Pressure Device
Full Face Mask Used With Positive Airway Pressure Device, Each
Humidifier, Heated, Used With Positive Airway Pressure Device
Continuous Airway Pressure (Cpap) Device
Face Mask Interface, Replacement For Full Face Mask, Each
Water Chamber For Humidifier, Used With Positive Airway Pressure Device, Replacement, Each
Chinstrap Used With Positive Airway Pressure Device
Respiratory Assist Device, Bi-Level Pressure Capability, Without Backup Rate Feature, Used With Noninvasive Interface, E.G., Nasal Or Facial Mask
(Intermittent Assist Device With Continuous Positive Airway Pressure Device)
Tubing With Integrated Heating Element For Use With Positive Airway Pressure Device
Respiratory Assist Device, Bi-Level Pressure Capability, With Back-Up Rate Feature, Used With Noninvasive Interface, E.G., Nasal Or Facial Mask (Intermittent
Assist Device With Continuous Positive Airway Pressure Device)
Humidifier, Non-Heated, Used With Positive Airway Pressure Device
Exhalation Port With Or Without Swivel Used With Accessories For Positive Airway Devices, Replacement Only
Oral Interface Used With Positive Airway Pressure Device, Each
Respiratory Assist Device, Bi-Level Pressure Capability, With Backup Rate Feature, Used With Invasive Interface, E.G., Tracheostomy Tube (Intermittent Assist
Device With Continuous Positive Airway Pressure Device)
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Hospital Beds and Related Accessories
HCPCS
Code
E0260
E0910
E0271
E0261
E0940
E0303
E0255
E0912
E0272
E0310
E0294
E0295
E0250
E0301
E0305
E0265
E0911
E0304
E0280
E0256
E0266
E0302
E0316
E0293
E0296
E0292
E0251
E0300
E0290
E0297
E0291
HCPCS Code Description
Hospital Bed, Semi-Electric (Head And Foot Adjustment), With Any Type Side Rails, With Mattress
Trapeze Bars, A/K/A Patient Helper, Attached To Bed, With Grab Bar
Mattress, Innerspring
Hospital Bed, Semi-Electric (Head And Foot Adjustment), With Any Type Side Rails, Without Mattress
Trapeze Bar, Free Standing, Complete With Grab Bar
Hospital Bed, Heavy Duty, Extra Wide, With Weight Capacity Greater Than 350 Pounds, But Less Than Or Equal To 600 Pounds, With Any Type Side Rails,
With Mattress
Hospital Bed, Variable Height, Hi-Lo, With Any Type Side Rails, With Mattress
Trapeze Bar, Heavy Duty, For Patient Weight Capacity Greater Than 250 Pounds, Free Standing, Complete With Grab Bar
Mattress, Foam Rubber
Bed Side Rails, Full Length
Hospital Bed, Semi-Electric (Head And Foot Adjustment), Without Side Rails, With Mattress
Hospital Bed, Semi-Electric (Head And Foot Adjustment), Without Side Rails, Without Mattress
Hospital Bed, Fixed Height, With Any Type Side Rails, With Mattress
Hospital Bed, Heavy Duty, Extra Wide, With Weight Capacity Greater Than 350 Pounds, But Less Than Or Equal To 600 Pounds, With Any Type Side Rails,
Without Mattress
Bed Side Rails, Half Length
Hospital Bed, Total Electric (Head, Foot And Height Adjustments), With Any Type Side Rails, With Mattress
Trapeze Bar, Heavy Duty, For Patient Weight Capacity Greater Than 250 Pounds, Attached To Bed, With Grab Bar
Hospital Bed, Extra Heavy Duty, Extra Wide, With Weight Capacity Greater Than 600 Pounds, With Any Type Side Rails, With Mattress
Bed Cradle, Any Type
Hospital Bed, Variable Height, Hi-Lo, With Any Type Side Rails, Without Mattress
Hospital Bed, Total Electric (Head, Foot And Height Adjustments), With Any Type Side Rails, Without Mattress
Hospital Bed, Extra Heavy Duty, Extra Wide, With Weight Capacity Greater Than 600 Pounds, With Any Type Side Rails, Without Mattress
Safety Enclosure Frame/Canopy For Use With Hospital Bed, Any Type
Hospital Bed, Variable Height, Hi-Lo, Without Side Rails, Without Mattress
Hospital Bed, Total Electric (Head, Foot And Height Adjustments). Without Side Rails, With Mattress
Hospital Bed, Variable Height, Hi-Lo, Without Side Rails, With Mattress
Hospital Bed, Fixed Height, With Any Type Side Rails, Without Mattress
Pediatric Crib, Hospital Grade, Fully Enclosed
Hospital Bed, Fixed Height, Without Side Rails, With Mattress
Hospital Bed, Total Electric (Head, Foot And Height Adjustments), Without Side Rails, Without Mattress
Hospital Bed, Fixed Height, Without Side Rails, Without Mattress
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Walkers and Related Accessories
HCPCS
Code
E0143
E0156
E0135
E0154
E0155
E0149
E0141
E0148
A4637
E0159
E0158
E0147
E0130
E0140
E0157
A4636
E0144
HCPCS Code Description
Walker, Folding, Wheeled, Adjustable Or Fixed Height
Seat Attachment, Walker
Walker, Folding (Pickup), Adjustable Or Fixed Height
Platform Attachment, Walker, Each
Wheel Attachment, Rigid Pick-Up Walker, Per Pair
Walker, Heavy Duty, Wheeled, Rigid Or Folding, Any Type
Walker, Rigid, Wheeled, Adjustable Or Fixed Height
Walker, Heavy Duty, Without Wheels, Rigid Or Folding, Any Type, Each
Replacement, Tip, Cane, Crutch, Walker, Each.
Brake Attachment For Wheeled Walker, Replacement, Each
Leg Extensions For Walker, Per Set Of Four (4)
Walker, Heavy Duty, Multiple Braking System, Variable Wheel Resistance
Walker, Rigid (Pickup), Adjustable Or Fixed Height
Walker, With Trunk Support, Adjustable Or Fixed Height, Any Type
Crutch Attachment, Walker, Each
Replacement, Handgrip, Cane, Crutch, Or Walker, Each
Walker, Enclosed, Four Sided Framed, Rigid Or Folding, Wheeled With Posterior Seat
DMEPOS Competitive Bidding Product Category/HCPCS List - Round 1 Rebid
Product Category: Support Surfaces (Group 2 mattresses and overlays) in Miami-Fort Lauderdale-Pompano Beach, Florida
HCPCS
Code
E0277
E0372
E0371
E0373
E0193
HCPCS Code Description
Powered Pressure-Reducing Air Mattress
Powered Air Overlay For Mattress, Standard Mattress Length And Width
Nonpowered Advanced Pressure Reducing Overlay For Mattress, Standard Mattress Length And Width
Nonpowered Advanced Pressure Reducing Mattress
Powered Air Flotation Bed (Low Air Loss Therapy)