CMS offers guidance on billing for complex rehab accessories

Guidance on rural rates still in the works
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Tuesday, December 27, 2016

WASHINGTON – CMS has updated the DME Center page of its website with information on how it plans to implement certain provisions in the recently passed 21st Century Cures Act.

For a provision that delays CMS’s plans to apply bid-derived pricing to accessories for complex power wheelchairs for another six months, until July 1, 2017, the agency states:

“To implement the extension, the 2016 KU fee schedule amounts have been updated by the 2017 0.7% covered item update and will be added to the 2017 DMEPOS fee schedule file. Suppliers should continue to use the KU modifier when billing for wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehab power wheelchairs with dates of services Jan. 1, 2017, through June 30, 2017.”

For a provision requiring CMS to retroactively delay reimbursement cuts that went into effect in non-competitive bidding areas from June 30, 2016, to Dec. 31, 2016, the agency states:

“CMS is currently working to implement this section and will be providing contractor instructions for re-processing the applicable claims. There is no action required for the suppliers at this time. Formal instructions will be issued in the near future.”

President Barack Obama signed the Cures Act on Dec. 13.