Every year, CMS publishes rulemaking about Durable Medical Equipment policies, often fairly inconsequential and often annexed to some passing major rule, like the annual ESRD rule.
In 2020, CMS made a more elaborate proposal (as well as as rolling up some DME topics in interim final rulemakings related to COVID last year). See 85 FR 70358, November 4, 2020, 57pp. CMS publishes new ways of making fee schedule adjustments outside of competitive bidding areas; CMS provides adjustments for rural areas; CMS provides rules for benefit category determinations for DME (and prosthetics etc, DMEPOS). Determining a benefit category sets whether something is payable at all, but the specific benefit category choosing will invoke different payments rules specific to that benefit.
As a side note, this benefit category thinking built into HCPCS decisions isn't brand new; many products for years and years have gotten a turn-down with the comment, "We do not believe there is a benefit category." And other items are assigned a code and a pricing method (such as an E-code and pricing as rental DME) meaning a benefit category choice was implicit.
Find The Stuff
Find the home page for the final rule here. Find the pre-publication or typescript inspection copy of the rule, 167 pp, here. On December 28, Fed Reg will release the final paginated and typeset version.
HCPCS "Theory and Goals" Simply Dropped from Final Rule; Bookmark the Proposed Rule