The Centers for Medicare & Medicaid Services (CMS) recently
released draft coverage criteria for power wheelchairs and
scooters, as well as new codes, to ensure proper payment.
To better reflect the range of power mobility products now
available on the market, Medicare will expand the number of codes
used for billing from five to 49. Individual payment ceilings will
also be developed for each of the new codes, which will go into
effect on January 1, 2006, CMS stated.
As mandated by the Medicare Modernization Act (MMA), CMS is also
developing quality and consumer standards for all suppliers of
durable medical equipment, prosthetics, orthotics, and supplies
(DMEPOS), as well as standards for specific product lines,
including power mobility devices.
CMS announced that it intends to finalize these standards in the
fall of this year and to implement them through an accreditation
process conducted by one or more accreditation bodies to be
designated at a later time.
The proposed National Coverage Decision will be posted on the CMS
website at www.cms.hhs.gov/coverage.
A description of the new billing codes for wheelchairs will be
posted on the CMS website at www.cms.hhs.gov/suppliers/dmepos
The O&P EDGE
April 2005
April 2005
