PSC Medical Directors Rescind ATP Evaluation Requirement Slated for April 1 Start

The medical directors for the Program Safeguard Contractors (PSC) have eliminated the requirement that patients receiving rehab power chairs on or after April 1 be evaluated by an assistive technology practitioner (ATP) who has been certified by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA).

The other part of the requirement — that such rehab equipment be supplied by a business that employs a RESNA-certified assistive technology supplier (ATS) or ATP for claims with dates of service on or after April 1 — will go forward as scheduled, the medical directors said. The ATS or ATP involved must have direct involvement in wheelchair selection for the patient in question.The announcement came at the start of December, after rehab industry insiders had warned for months that not enough ATPs would be certified by the April 1 start date. Industry experts worried that evaluations would be backlogged because of the lack of ATPs qualified to conduct the seating & mobility evaluations, and therefore that timely beneficiary access to rehab power chairs would be compromised.

In announcing their decision, the medical directors — Dr. Paul Hughes (Jurisdictions A&B), Dr. Mark D. Pilley (Jurisdiction D) and Dr. Adrian Oleck (Jurisdiction C) — cited input from the American Occupational Therapy Association, the American Physical Therapy Association and the American Association for Homecare. Instead of the ATP evaluation requirement, the current requirement will remain in place: For patients receiving Group 2 single power option or multiple power option power wheelchairs (PWC), any Group 3 or Group 4 PWC, or a pushrim-activated power-assist device for a manual wheelchair, evaluations must be “performed by a licensed/certified medical professional, such as a PT (physical therapist) or OT (occupational therapist), or physician who has specific training and experience in rehabilitation wheelchair evaluations and that documents the medical necessity for the wheelchair and its special features. ”

The amended requirement will be included in a future version of the power mobility device local coverage determination.

This article originally appeared in the January 2008 issue of Mobility Management.

Mobility Management Podcast