Update: Custom seats, backs under review, NCART says

Tuesday, April 25, 2017

WASHINGTON – The medical directors at jurisdictions B and C have agreed to do an “immediate review” of payments for custom seats (E2609) and custom backs (E2617), following their decision to change payments from individually priced to flat allowable, according to NCART. “In the interim, they are holding the processing of any claims that include E2609 and E2617 until they have determined any needed changes,” stated Don Clayback, executive director of NCART, in an email to members on April 24. “Our hope is this review and the need to hold these claims will be concluded in the next seven to 10 days.” Industry stakeholders argue that the two codes are custom items and, therefore, should be individually priced. Under the change, E2609 would have a set price of $450 and E2617 $550, according to previous reports. “We have also emphasized that the reduction in access to these products not only compromises the ability of Medicare beneficiaries with significant disabilities to get needed custom seating, but without this custom seating, the vast majority will be unable to even use their wheelchairs,” Clayback stated.