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reddenda
DME
Index online  ·  Data sourced from: CMS 2026 DMEPOS Fee Schedule  ·  TiC MRF filings (Jan-May 2026)  ·  2.4M+ contracted rates indexed  ·  Updated monthly
// DME Supplier Account

DME Supplier

HCPCS rate intelligence · Allowed amount variance by payer and product line
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Founder's Promise applies to DME suppliers.
If your paid Rate Audit does not identify documented reimbursement opportunity above your account's promise floor across your HCPCS and payer book, we refund your fee. Actual recovery depends on payer response, contract terms, and negotiation outcome.
Run the Rate Audit ·
Documented Rate Gap
HCPCS Codes Benchmarked
Codes Below Median
Worst Payer
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Competitive Bid Is The Floor, Not The Book
Medicare DMEPOS is competitive bid. Your commercial contracts are not, and that is where the spread lives. CBA pricing overrides fee schedule rates in select markets for oxygen, standard power wheelchairs, and CPAP. Rates shown reflect indexed commercial contracts unless otherwise noted.
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Prior Authorization Burden
High prior auth burden categories (power mobility, custom rehab, spinal orthoses) may constrain billing volume independent of contracted rate. Factor prior auth approval rates into your opportunity estimates before initiating renegotiation.
// Top HCPCS Allowed Amount Gaps

Per-unit gap = your indexed contracted rate vs the regional p50 benchmark. Annual figure requires DMEPOS service volume.

HCPCS
Contracted (You)
Regional P50
Regional P75
Gap / unit
Status
Status: Below median Your indexed rate sits below the regional p50 for this code At/above At or above the regional p50 benchmark Excluded Codes with fewer than 500 peer rates are not benchmarked
// Allowed Amount Variance by Payer

Summed per-unit variance by payer across your benchmarked HCPCS codes.

Per-Payer Allowed Amount Variance
// Recommended Next Steps
1
Generate a leverage memo for your most underpaid HCPCS code
Payer-ready PDF Federal TiC citations
The memo pulls your indexed contracted rate, the regional p50 benchmark, and the documented per-unit gap for the code and payer you select from the table above.
Generate Memo
2
Confirm prior auth approval rates before negotiating
Power mobility Custom rehab Orthotics
Prior auth burden on power mobility and orthotics can suppress your effective volume. Confirm approval rates before initiating rate negotiation so your documented opportunity is never overstated.
Review
3
Add DMEPOS unit volume to convert per-unit gaps into annual exposure
Per-unit today Annual $ with volume
Your dashboard documents the per-unit gap on every benchmarked code. Adding monthly unit volume per code turns those gaps into a defensible annual exposure figure.
Add Volume
// HCPCS Categories Covered
Oxygen
E1390 E0431
Sleep
E0601 E0470
Mobility
K0001 K0003
CGM
A4239 E2103
Orthotics / Prosthetics
L0650 L3960
Example codes per HCPCS family. Your own codes appear in the gaps table once your indexed contracted rates match codes with sufficient peer data. Where coverage is still building for a family, we say so on the line.
// Which Payer Renews Next?
Turn your HCPCS gap data into payer-ready leverage.
Start with the contract that renews next. The leverage memo converts a documented per-unit gap into a payer-ready document with a federal TiC citation on every line. The Rate Audit covers the whole book: every location, every HCPCS family, under the Founder's Promise. Documented reimbursement opportunity above your promise floor, or we refund your fee.
Generate HCPCS Leverage Memo Run the Rate Audit ·