Frequently Asked Questions

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FAQ

How did CMS calculate the values in the Referring Provider DMEPOS PUF?

The spending and utilization data in the Referring Provider DMEPOS PUF are aggregated to the following: the NPI for the referring provider, the Healthcare Common Procedure Coding System (HCPCS) code from DMEPOS supplier claims, and the supplier rental indicator (value of either ā€˜Yā€™ or ā€˜Nā€™) derived from HCPCS code modifiers on DMEPOS supplier claims. There can be multiple records for a given referring NPI based on the number of distinct HCPCS codes that are billed by DMEPOS suppliers. Furthermore, there can be multiple records for the same HCPCS code in cases where both rental and purchase of a product has been referred by the NPI.  Data has been aggregated based on the supplier rental indicator because separate fee schedules apply for rental versus purchase of products.


HCPCS codes identify the medical products and services furnished by physicians and other healthcare professionals. For additional information on HCPCS codes, visit http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html


(FAQ12757)

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