From NCART: CMS Publishes Initial Implementation Instructions

Published in Complex Rehab on January 30, 2020

In a recent announcement from NCART, it was announced that CMS released initial instructions on implementation of the Complex Rehab Manual Wheelchair accessories legislation (H.R. 1865) that passed in December. This provides an 18-month suspension in Medicare's application of Competitive Bidding Program payment rates to these items. A summary of the highlights are below, and the full announcement can be read here.

  • CMS specifically identifies "CRT manual wheelchairs" as codes E1161 and K0005, and also includes the other manual wheelchair codes (defined as as HCPCS codes E1235, E1236, E1237, E1238, and K0008) in the legislation.
  • The new rates are effective January 1, 2020, but "it is unlikely that changes to the Medicare claims processing system can be implemented sooner than July 1, 2020 and possibly later".
  • For now, providers should continue to bill accessories as they have been doing, and claims will be paid at the Competitive Bid adjusted rates.
  • Once the claims processing systems are updated, "payment at the full fee schedule amounts for claims submitted for these items with dates of service on or after January 1, 2020 will be available retroactively". 
  • CMS indicated additional information, including a list of HCPCS codes for accessories affected, as well as further instructions regarding the submission and processing of claims will be provided in coming months.

NCART has been in contact with CMS, and a joint work group of CRT stakeholders will be developing questions and suggestions. These comments will include finalizing the system change as soon as possible, adding pediatric size tilt-in-space wheelchair codes, and streamlining the process of securing retroactive payments. More updates will be shared as additional details are received.

Interested in becoming more involved with CRT advocacy? Consider an NCART membership!

Increasing CRT coverage and payment challenges are making it more difficult to provide quality products and service to people with disabilities. NCART’s work brings together dedicated providers, manufacturers, and other advocates in the fight to protect access to CRT at the federal and state levels. As an independent complex rehab provider, we strongly encourage you to consider joining this membership to further the important advocacy work being done today. Your membership will ensure people with disabilities in your community and across the country can access the critical CRT equipment and services you provide. For more information, please visit the membership area of NCART’s website at www.ncart.us.  


comments powered by Disqus

From Our Experts

The Importance of Training Techs in the Complex Rehab Industry thumbnail The Importance of Training Techs in the Complex Rehab Industry Worker shortages are prevalent in every sector of the economy; the complex rehab technology (CRT) industry is no exception. ATPs as well as repair technicians are in short supply. But what is being done to help address both of these needs? Training is one of the answers. Branding Matters. A Lot. To Your Customers and Your Bottom Line thumbnail Branding Matters. A Lot. To Your Customers and Your Bottom Line Your company's brand is the most valuable business asset you own. Branding is the single most important thing you can do to positively affect your revenue. As you begin planning for 2022, give these two things a little love, and your business will grow significantly. Referral Source Marketing in Today's Environment thumbnail Referral Source Marketing in Today's Environment Whether you realize it or not, DMEPOS companies today need to put a lot of strategy and thought behind their marketing efforts. Let's look at some steps you should consider to help your referral source marketing efforts in the current landscape. While the focus will be on individuals and organizations supplying care, I'll touch on payers briefly too, as there is some overlap in tactics. How a Successful Marketing Strategy Leads to a Better ROI for Your Business thumbnail How a Successful Marketing Strategy Leads to a Better ROI for Your Business Sleep Solutions Home Medical is quite innovative when it comes to marketing and varying sales strategies. Robyn Parrott and Katie Parrott discuss marketing strategies to consider for the coming year. Prospecting 101 thumbnail Prospecting 101 After many years in the sales and marketing arena, Rhonda McCumber has found that it's extremely important to know and understand both the industry and the audience you wish to connect with. The first step in doing this is to learn how to prospect successfully. New DMERT Group Website Unveiled thumbnail New DMERT Group Website Unveiled The DMERT Group is excited to unveil their newly redesigned website. PR: Proactive Relations, Not Public Relations thumbnail PR: Proactive Relations, Not Public Relations Originally featured in VGM's recent playbook, Optimizing Sales and Marketing in the DMEPOS Space, Mandi Joyner discusses why and how a good public relations strategy should not just complement your marketing efforts but should be an integral part of them. ATP Renewal Guidelines During the PHE thumbnail ATP Renewal Guidelines During the PHE COVID-19 has brought about several challenges to our businesses, including meeting standard guidelines for ATP renewal or recertification. RESNA's PSB has decided to review renewal situations on a case-by-case basis.