CMS revises fee schedule

Thursday, November 30, 2006

WASHINGTON - The rehab industry's lobbying efforts have paid off somewhat, with "significant" reimbursement increases for certain power mobility devices.
CMS released a revised fee schedule Nov. 11 after industry officials successfully argued that the rate of inflation used to determine pricing for some PMDs was inconsistent with the rate used for others.
"CMS addressed a lot of the changes we had been communicating with them about," said Don Clayback, who heads up The MED Group's rehab network.
The reimbursement for the Group 2 standard power wheelchair (K0823), for example, increased 8% or $301 from the original reimbursement released in October. CMS also softened the blow for numerous Group 3 chairs, but cuts still remain across-the-board.
Eric Sokol, director of the Power Mobility Coalition, said the bump was welcome--but it's not enough. In a release, the PMC pointed out that reimbursement for the most frequently prescribed power wheelchairs is still 15% to 35% less than current reimbursement.
"If these prices go into effect (Nov. 15), it's not going to cover the costs of these providers," said Sokol. "They'll have to either stop participating in the Medicare program, concentrate on other products or close their doors."
Dan Meuser, president of Pride Mobility Products, agreed. "It's going to be impossible for providers to provide some of these wheelchairs," he said. "You can drown in 25 feet of water as easily as you can drown in 250 feet of water."
The revised fee schedule was enough, however, for Tim Pederson to reconsider dropping power wheelchairs from his product mix.
"Now we don't have to do that," said Pederson, CEO of WestMed Rehab in Rapid City, S.D., and vice chairman of AAHomecare's rehab council.