Thursday, March 30, 2023

CMS RFI: Pricing, Data Analysis & Coding Contractor (PDAC) Services

Notice ID: 230542


The Pricing, Data Analysis and Coding (PDAC) contract is designed to provide specified services in support of the sound administration of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) benefits within the “traditional” Medicare Fee-For-Service (FFS) program under the direction of CMS. The Contractor shall facilitate, coordinate, and support activities among various Medicare contractors with DMEPOS-related responsibilities (e.g., Durable Medical Equipment (DME) Medicare Administrative Contracts (MACs), Unified Program Integrity Contractors (UPICs), and the National Supplier Clearinghouse (NSC)) as well as other agencies (at the federal and state levels of government) and other stakeholders. The successful offeror shall receive and control Medicare national DMEPOS claims data from CMS. The Contractor conducts a variety of different supplier services, such as answering written and telephone inquiries and providing Medicare guidance and advice on coding of DMEPOS claims. This Statement of Work (SOW) applies to the Medicare FFS DMEPOS-related pricing, data analysis and coding support functions activity only. This Contractor shall function as a National contractor.

The tasks required for this project are:

  • Administer Healthcare Common Procedure Coding System (HCPCS) for DMEPOS
  • Provide Medicare Coding Advice and Guidance for DMEPOS Items
  • Establish and Distribute Pricing Files for Certain Drugs and DMEPOS Items
  • Conduct DMEPOS-Related Statistical Analysis and Reporting Activities
  • Support the Integrity of the Medicare FFS DMEPOS Benefit
  • Other Contractor Activities: Spring and Fall DME Coordination Meetings, Data Warehouse, Web Technology

Read more here.


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Jackie Gilbert
Jackie Gilbert
Jackie Gilbert is a Content Analyst for FedHealthIT and Author of 'Anything but COVID-19' on the Daily Take Newsletter for G2Xchange Health and FedCiv.

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