Tag: Group 3 power wheelchairs

WASHINGTON - CMS has announced the first two codes that will require prior authorization as a condition of payment.In a final rule published in the Federal Register on Dec. 21, the agency says it will apply the PA process for two Group 3 power wheelchair codes, K0856 and K0861, in two phases on March 20, 2017, and July 17, 2017.In phase one, CMS will limit the PA requirement to one state in each of the four DME MAC jurisdictions. The states are Illinois, Missouri, New York and West Virginia.“Initially...

YARMOUTH, Maine - Some providers say they're cutting back on offering certain products and services after CMS said it would pay them at reduced payment amounts for accessories used on Group 3 power wheelchairs."We're taking it on a case-by-case basis, looking at each piece of equipment and determining if that's something we can provide through Medicare," said Sean Andrews, finance manager at Bedard Pharmacy & Medical Supplies in Auburn, Maine. “We get requests for specific equipment from therapists...

WASHINGTON - Stakeholders were flabbergasted last week when CMS issued billing instructions for accessories for Group 3 power wheelchairs.In the instructions, CMS says it will use an adjusted fee schedule based on competitive bidding rates for these accessories,despite a law passed in 2015 delaying that change for one year. The reason: The agency says it can't adjust its claims processing systems for at least six months.“CMS has implemented these kinds of payment changes for doctors and other...