CMS Postpones DME Face-to-Face Implementation

• By Laurie Watanabe
• Jun 28, 2013

Acknowledging that stakeholders might need more time to prepare for a major change in workflow, the Centers for Medicare & Medicaid Services (CMS) has postponed implementation of its face-to-face requirement for many types of DME.

The announcement came just days before the previously scheduled July 1 implementation date.

CMS now says it "will start actively enforcing and will expect full compliance" with the new face-to-face requirement starting Oct. 1, 2013.

This face-to-face requirement applies to a wide range of DME, including manual wheelchairs (HCPCS codes K0001, K0002, K0003, K0004, K0005, K0006, K0007, K0009); various pediatric wheelchairs (E1232-1238, E2227); transport chairs; manual wheelchairs with tilt, adult sizes (E1161); various wheelchair accessories, including ventilator trays, manual elevating legrests, manual power-assist systems, manual positioning components; and transfer systems.

According to the new requirement, a physician, physician assistant, nurse practitioner or clinical nurse specialist must conduct and document a face-to-face examination of a Medicare beneficiary sometime in the six months prior to the written order for the DME.

Existing face-to-face policies for power mobility devices (PMD) will continue to be enforced, as PMD are not among the products impacted by the new requirements.

"Although many durable medical equipment suppliers and physicians are aware of and are able to comply with this policy, CMS is concerned that some may need additional time to establish operational protocols necessary to comply with this new law," CMS said in announcing the implementation delay.

For more details about the delay, the new requirement or for a full list of affected equipment and HCPCS codes, click HERE.