CMS: An accessory is an accessory is an accessory

Friday, June 19, 2015

WASHINGTON – CMS is standing by its decision to apply competitive bidding pricing to accessories for complex rehab wheelchairs. In response to a “Dear Colleague” letter from 100 members of the House of Representatives, the agency says applying the pricing to all accessories, regardless of what type of base equipment is used, “avoids complexity and confusion associated with including the same accessory in multiple competitive bidding programs.” CMS also says the cost of accessories doesn’t vary significantly based on the type of base equipment. “The HCPCS codes describe wheelchair accessories that are used interchangeably on different wheelchair bases,” the agency states. “ While there is always a range of products with different costs that fall under each HCPCS code, the Medicare payment amount represents payment for the category of items as a whole, and should be sufficient to cover the average costs of items falling under the code.” The industry has argued that because complex rehab wheelchairs have been excluded from competitive bidding, accessories used on those wheelchairs shouldn’t be reimbursed at the bid rate. Stakeholders believe the change, due to go into effect Jan. 1, could result in payment cuts ranging from 20% to 50% for accessories for complex rehab wheelchairs.