Determining if an off-the-shelf brace is included in the 2021 Competitive Bidding Program (CBP) may take a bit of research.

But there’s a quick, easy way to get product information. An online lookup tool makes it simple: All you need is the Healthcare Common Procedure Coding System (HCPCS) product code.

Access the Tool

The Competitive Bid HCPCS Lookup Tool is provided by Noridian Healthcare Solutions, a jurisdictional administrative contractor for the Centers for Medicare & Medicaid Services (CMS). The tool includes HCPCS codes listed on the CMS DMEPOS CBP Round 2021 website.

Simply enter the HCPCS code in the entry field on the tool and click “Check.”

The tool will quickly let you know if the HCPCS code is included in the current competitive bidding program.

Learn More

If the HCPCS code is part of the program, the lookup tool will also provide links to additional guidance, including:

• Round 2021 CBA Zip Code Lookup Tool. This tool will help you determine if the beneficiary’s permanent address zip code is in a competitive bidding area. All you need is the zip code of the beneficiary’s permanent address.
• Prior Authorization. This link will take you to the list of all HCPCS product codes that require prior authorization.
• Face-to-Face and Written Order Prior to Delivery List. This link will take you to the list of all HCPCS product codes that require a face-to-face visit and written order prior to delivery.

Here to Help

ACHC is your partner in accreditation. For information on DMEPOS Accreditation, email [email protected] or call (855) 937-2242, ext. 458.