CMS to Announce Rehab Transition Policy for NCB Areas
The Centers for Medicare & Medicaid Services (CMS) will issue one-time transition instructions for suppliers who provide certain types of rehab to beneficiaries in national competitive bidding (NCB) areas on or after July 1, 2008 - the day competitive bidding pricing and policies are due to officially be implemented.
Affected by this transition policy will be suppliers who "begin furnishing services related to providing these devices, but do not deliver the final PMD (power mobility device) product" until July 1 or later. In those cases, CMS said in a May 20 news release that payment will be "based on the 2008 fee schedule amounts for furnishing these PMDs to beneficiaries residing in round one CBA (competitive bidding areas). This transition policy applies to both contract and non-contract suppliers."
PMD with HCPCS codes K0856 through K0864 will be eligible for the transition policy, CMS said, if the signed physician order is dated between April 1 and May 31, 2008; and documentation of the face-to-face physician examination to determine medical necessity occurred before July 1.
For these types of cases during this transition period, CMS said suppliers should use the date of the physician order as the date of service on the claim. Usually, suppliers are to use the item delivery date as the date of service.