CMS delays implementing new PWC codes

Sunday, October 16, 2005

WASHINGTON - CMS announced Friday afternoon that it will delay the Jan. 1, 2006, implementation date for 62 new codes for power mobility devices. In a release, CMS stated that it "now plans to delay implementation of these new codes until it has an opportunity to review the changes with input from manufacturers, suppliers and other stakeholders."

The delay is good news for industry manufacturers, who were outraged when CMS blindsided them Sept. 14 by increasing without any advanced notice the number of new wheelchair and scooter codes from 49 to 62. CMS announced the 49 new codes in February and gave manufacturers until Sept. 1 to test products -- at a cost of many thousands of dollars -- and submit the results to the SADMERC, which assigned the product to the new codes.

Earlier this month, Invacare's vice president of government relations told HME News that the testing requirements for the 62 new codes were not consistent with industry standards. Bachenheimer and others also expressed doubt that the new codes could be implemented Jan. 1 without causing major industry upheaval.

A major concern was that CMS would try to assign or cross walk products to one of the 62 new codes with little or no additional testing.

"If you have this fiction that a product meets the requirements and code descriptor, but it really doesn't, then you are setting pricing for a product that doesn't meet the code criteria," Bachenheimer said. "Does that make sense? No."

CMS increased the 49 codes to 62 after becoming aware last summer of all the lightweight products now on the market, said a DMERC official.

"There was a big scramble for them to decide how to include them," the DMERC source said. "The policy needed to be done and fit the timeframe."