CMS clarifies payments for wheelchair accessories

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Wednesday, August 20, 2014

WASHINGTON – CMS has published a change request (8864) that instructs contractors to update systems allowing payment for wheelchair accessories when provided for use with non-competitively bid wheelchair base units after the end date of the certificate of medical necessity and when the modifier “KY” is present. The change applies to payments for wheelchair accessories furnished for use with Group 2 and Group 3 power wheelchairs by contractors in a competitive bid area (CBA); for competitively bid wheelchair accessories furnished for use with wheelchair base units not bid in Round 1 or Round 2 by contract and non-contract suppliers for beneficiaries living in a CBA; for competitively-bid wheelchair accessories not bid in Round 1 but furnished for use with any wheelchair base to beneficiaries living outside a CBA; and for competitively bid wheelchair accessories not bid in Round 1 and that were furnished for use with wheelchair base units not competitively bid in Round 2 to beneficiaries living in a CBA. The changes take effect for claims processed starting Jan. 5, 2015.