CMS revamps cushion allowables

Sunday, October 31, 2004

November 1, 2004

WASHINGTON  - For nearly three weeks manufacturers and providers voiced concern that new Medicare allowables for adjustable skin and combination cushions were way too low and would restrict access. Last week, CMS heeded those warnings and announced it would revamp allowables for those products.
As of Oct. 25, any adjustable skin and combination cushion previously assigned by the SADMERC to codes K0652 (adjustable skin protection) and K0656 (adjustable skin and positioning) will be reassigned to the K0108 miscellaneous code. Reimbursement for these products will be based on individual consideration the submitted charges.
In another key move, the SADMERC last week announced that the allowable fees for K0658 and K0666 HCPCS codes (custom molded seat and back respectively) have been changed to individual consideration. This changes will be retroactive to October 1, 2004.
Providers and manufacturers cheered both moves.
"We are pleased because Medicare recipients can now get the products they need," said Patrick Meeker, clinical applications manager for The Roho Group. "Providers were in an ethical quandary. Did they provide the product they knew the client needed or a product they knew they could get paid for?"