Your bid amount for each lead item must be at or below the 2019 unadjusted fee schedule amount for the state in which the competitive bidding area (CBA) is located. The unadjusted fee schedule amount is the updated historic fee schedule amount without any reductions based on competitive bidding information.
Your bid amount must be bona fide – i.e., rational, feasible, supportable – and should include your total cost to buy the item, including overhead and profit. You should consider the costs associated with furnishing the lead and non-lead items to Medicare beneficiaries throughout the CBA when submitting your bid amount for the lead item. Please refer to the Lead Item Pricing Calculator to determine the impact of your bid amount for the lead item on the non-lead items in in the product category. For additional information on the lead item pricing methodology, refer to the Lead Item Pricing fact sheet.
If the Centers for Medicare & Medicaid Services (CMS) has a question about your bid amount during bid evaluation, you may be asked to upload rationale and supporting documentation, such as a manufacturer’s invoice, in Connexion, the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program’s secure portal, to verify that you can provide the lead item for the bid amount indicated on your bid. For additional information, please see the Requirement to Submit a Bona Fide Bid fact sheet.
The bid limit for the lead item in a product category is for the purchase price of a new item, except for the oxygen and oxygen equipment and non-invasive ventilators product categories. For these two product categories, the bid limit is for one month’s rental for the lead item. The monthly rental bid limit is calculated to be equal to 10 percent of the purchased unit allowed amount.
The files below contain the bid limit amount for each lead item in each CBA.