ATP requirement riles providers

Wednesday, February 28, 2007

ALEXANDRIA, Va. - Although CMS still wants to require independent ATPs to perform evaluations for certain power wheelchairs, it's not dead set on making April 1, 2008, the requirement's implementation date. That's what Seth Johnson, chairman of AAHomecare's rehab council, told providers who listened in on the association's Jan. 25 teleconference on power mobility devices.
"I know that CMS has heard from the industry about extending the April 1 deadline, and they are open to discussing that," said Johnson, vice president of government affairs for Pride Mobility.
The teleconference comprised a 60-minute overview of coding, coverage criteria and pricing for PMDs, followed by a 30-minute question-and-answer period. Much of the latter was dedicated to CMS's ATP requirement.
Several listeners commented that they didn't think there were any independent ATPs in their area. One provider in southern New Jersey noted that he works with a handful of sub-acute care facilities and none of them have ATP-certified therapists.
"You'd have to go into Philly to find an ATP," said the listener. "That would mean a patient (or the ATP) would have to travel an hour."
During the teleconference, Johnson also discussed CMS's plans to:
* Adjust reimbursement for expandable controllers. On Jan. 1, the agency began reimbursing $485.71 for controllers for initial use (versus $1,342.27 for replacement). That doesn't make sense, Johnson said.
* Release final testing requirements for PMDs. Expect them in late January or early February.
* Revamp coding, coverage criteria and pricing for manual wheelchairs (See story page 1).
* Modify the way it develops new reimbursement rates. The agency plans to replace gap filling with a new methodology that involves assessing functionality, comparing prices and evaluating effectiveness. The methodology's "subjective" nature concerns the industry, Johnson said.