NCART fights for separate billing

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Friday, January 27, 2017

WASHINGTON – NCART has formed a work group and developed an issue paper in response to CMS’s decision not to allow separate billing for titanium wheelchair frames and heavy duty upgrades.

The agency argues these features are included in the initial fee schedules developed for manual wheelchairs.

“This is the most recent example of policy changes and re-interpretations over the past few years implemented by CMS and its contractors that eliminate access,” said Don Clayback, executive director of NCART. “This policy announcement prevents Medicare beneficiaries with disabilities from obtaining complex rehab technology, even in they are willing to pay for the upgrades themselves.”

In its issue paper, NCART argues that CMS must rescind the announcement, and issue a policy clarification stating suppliers can use K0108 to bill for titanium for wheelchairs for K0005, and can use K0108 to bill for heavy duty upgrades for K0004, K0005 and E1161 manual wheelchairs.

NCART says it has reached out to CMS to express its concerns, and is pursuing “other channels in the congressional and advocacy arenas.”