CMS Policy Impacts Payment for Accessories for Group 3 Complex Rehab Power Wheelchairs

The Centers for Medicare and Medicaid Services (CMS) recently announced their intent to adopt a new interpretation of the statute that impacts how adjustments to the fee schedule based on information from competitive bidding programs apply to wheelchair accessories used with Group 3 complex rehabilitative power wheelchairs. As of July 1, 2017, the fee schedule amounts for wheelchair accessories and back and seat cushions used with Group 3 complex rehabilitative power wheelchairs will not be adjusted using information from the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program. Instead, the fee schedule amounts will be based on the unadjusted fee schedule amounts updated by the annual fee schedule covered item update. Suppliers are being instructed to continue to use the KU modifier when billing for wheelchair accessories and seat and back cushions furnished connection with Group 3 complex rehabilitative power wheelchairs with dates of service beginning July 1, 2017. This new action will help to protect access to complex rehabilitative power wheelchair accessories for those individuals that depend on them.