CMS Proposes Wheelchair Codes

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  

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