NCART: Medicaid Reimbursement Raises Needed for Complex Rehab Technology

Published in Government Relations and Regulatory Assistance on July 11, 2023

Wayne Grau

This article was originally featured in HME Business

NCART is urging state Medicaid programs to raise their reimbursement rates for Complex Rehab Technology (CRT).

In a June 26 announcement, NCART cited the rising costs of doing business in saying it “has contacted state Medicaid agencies to request increases to reimbursement rates for CRT. The Centers for Medicare & Medicaid Services (CMS) announced a Medicare inflation increase for all CRT providers which went into effect in January 2023; NCART is emphasizing the need for states to follow the lead of CMS and urging them to make similar reimbursement adjustments to ensure continued access to vital equipment.”

NCART said inflation and other rising costs have hurt CRT providers and manufacturers: “Increased shipping costs, which have risen up to 40 percent due to various charges and surcharges, coupled with soaring raw material prices, have forced major manufacturers to implement price increases. Additionally, increased delivery costs like gasoline prices have further burdened the industry.”

The organization added that unlike other industries, CRT suppliers cannot simply pass these higher costs on to their customers.

“CRT providers are bound by fixed Medicare, Medicaid, and third-party payer fee schedules, leaving them unable to raise prices to cover rising costs,” NCART said. “Without fee schedule adjustments that align with market realities, it becomes increasingly unsustainable for manufacturers and providers to maintain critical access for people with disabilities.”

Wayne Grau, NCART’s Executive Director, said in the announcement, “Complex Rehab Technology plays an irreplaceable role in maximizing independence, quality of life, and community access for individuals with significant disabilities. We are calling on payers to acknowledge the considerable cost increases associated with providing CRT equipment and make corresponding reimbursement adjustments. This is crucial to ensure that people in need can continue to receive the equipment they rely on.”

From Our Experts

CMS Public Meeting - Seat Elevation Coding and Reimbursement thumbnail CMS Public Meeting - Seat Elevation Coding and Reimbursement Earlier this month CMS announced preliminary recommendations for coding and pricing of power seat elevation systems. The preliminary decision can be read here. Monthly Update Released by NCART in NCART News thumbnail Monthly Update Released by NCART in NCART News Here is some of what you might have missed in this months NCART news. [Breaking News] CMS Announces a Huge Win for Power Seat Elevation thumbnail [Breaking News] CMS Announces a Huge Win for Power Seat Elevation the Centers for Medicare & Medicaid Services (CMS) has determined that power seat elevation equipment on Medicare-covered power wheelchairs (PWCs) falls within the benefit category for durable medical equipment (DME). Washington Governor Sign SB 5218 to Remove Sales Tax From CRT Equipment thumbnail Washington Governor Sign SB 5218 to Remove Sales Tax From CRT Equipment On May 4 in Olympia, Washington, Governor Jay Inslee signed SB 5218 into effect. This bill exempts complex rehab technology (CRT) equipment from sales tax, making it more accessible and affordable for those in need of it. CMS Opens Comment Period for Power Seat Elevation Coverage thumbnail CMS Opens Comment Period for Power Seat Elevation Coverage Last week, CMS announced the opening of a comment period relating to the request for Medicare coverage of power seat elevation systems used with complex power wheelchairs. Senate Dear Colleague Letter on Power Seat Elevation and Standing Systems Begins to Circulate thumbnail Senate Dear Colleague Letter on Power Seat Elevation and Standing Systems Begins to Circulate Please reach out to your representatives to ask them to sign the Dear Colleague Letters, which request that CMS advance Medicare coverage for power seat elevation system and urge them to promptly move forward with the process for power standing systems. U.S. Rehab and VGM Government Relations Attend Congressional Briefing in Washington D.C. thumbnail U.S. Rehab and VGM Government Relations Attend Congressional Briefing in Washington D.C. Wednesday, Sept. 14, was a momentous day of advocating for CRT and other key legislative issues. Greg Packer and Tom Powers spent time in Washington D.C. attending the NCART/NRRTS Virtual Congressional Fly-In and a congressional briefing on power seating and standing systems for power wheelchairs. CMS Final HCPCS Coding Decision for Seat Elevation thumbnail CMS Final HCPCS Coding Decision for Seat Elevation The Centers for Medicare & Medicaid Services (CMS) has recently released the final rule regarding seat elevation. Unfortunately, it was not the outcome we had hoped for, or expected.