Wheelchair repairs: CMS addresses service fees

Thursday, April 9, 2009

YARMOUTH, Maine – The DME MACs on April 9 issued a highly anticipated FAQ on the new billing policy for wheelchair repairs.

In the FAQ, the DME MACs answer nine questions, including “If the beneficiary refuses to bring their equipment to the supplier location, can they be charged a fee for this service?”

The answer: “No, Medicare’s payment for repairs, i.e. parts and labor, is all-inclusive. There is no separate payment for travel time, service charges, fuel charges, etc. On an assigned claim, suppliers may not charge a beneficiary for these costs. On a nonassigned claim, they beneficiary will be responsible for the difference between the submitted charges for the repairs and the amount Medicare pays.”

Starting April 1, providers had to start billing for wheelchair repairs using standardized labor times. With each allowed unit of service representing 15 minutes of labor, they’re now allowed to bill two units to repair or replace a battery on any power wheelchair; one unit to repair or replace each wheel or tire on any power or manual wheelchair; and so on.

To read the FAQ, go to: http://www.cignagovernmentservices.com/jc/pubs/news/2009/0409/cope9691.html