Complex Manual Wheelchair Accessories Increase in 2020 - How Did Your Representative Vote?

Published in Complex Rehab on Friday, February 7, 2020

buildingOn December 20, 2019, H.R. 1865, which included permanent protections for Complex Rehab Manual Wheelchairs and their accessories/components, was signed into law! One of the key provisions is an 18-month suspension in the current application of CBP payment rates to Complex Rehab Manual Wheelchair accessories. The suspension is effective Jan. 1, 2020 to June 30, 2021. What this means is for dates of service from Jan. 1, 2020 - June 30, 2021, accessories on complex manual bases (E1161 and K0005) will reimburse at the unadjusted fee schedule. This will increase the overall claim reimbursement by an average of $300. We believe the accessories on complex manual bases will require the KU modifier to pull from the unadjusted fee schedule.  

However, the Medicare system is not currently updated for this change, and based off of a recent CMS release, this won't be updated until July 2020. This means that you should continue doing things as you have been until further notice, but keep track of claims for K0005 and E1161 with dates of service Jan. 1, 2020 on and be prepared to submit for a written reopening to request to have the claims adjusted. Once we are notified that the system has been updated, you will be able to begin submitting new claims with the appropriate modifier and submit the past claims for adjustment. Keep in mind that your submitted charge must be more than the allowable in order for them to adjust the claim in the future. Review the KU allowables to ensure your submitted charge is at least at the KU level.

Now let's see if your representative voted to support our industry. Please click the links below to see how your representative voted on this bill. If they voted Yea, thank them, and if they voted Nay, ask them why they didn't support our industry, and consider that when you cast your vote.  

Roll Call Vote 116th Congress - 1st Session 

Final Vote Results For Roll Call 689 

If you have any questions, please contact me at [email protected] or 570-499-8459. 


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