The Medicare allowable for seat elevation on a Complex Rehab Technology (CRT) power chair is getting a very modest increase.
In a June 25 bulletin, the National Coalition for Assistive & Rehab Technology (NCART) said it had been notified that the allowable for HCPCS code E2298 — Complex rehabilitative power wheelchair accessory, power seat elevation system, any type — would be increased by $13.62, for a total fee schedule amount of $2013.96.
NCART added that the changes “are being implemented as part of the July DMEPOS fee schedule update, along with instructions for submitting previously processed claims for adjustment.”
The CMS decision letter was signed by Joel Kaiser, director, division of DMEPOS policy, and was addressed to NCART Executive Director Wayne Grau, who had asked CMS to reexamine its payment calculations for E2298.
Kaiser said in the letter that because the final payment determination has already been released, “We are limited in our review to errors that may have occurred in our calculation of payment amount. For example, additional wheelchair models with seat elevation equipment that were not brought to our attention through the public meeting process cannot now be added as part of our review of the calculation of the fee schedule amount for code E2298.”
Kaiser attributed the difference between the CMS fee schedule amount and the reimbursement amount calculated by CRT industry experts to “a number of differences between the prices used in your calculation and ours, along with an error in our calculation. … In our final payment determination, we used lower internet prices for 12 models compared to the prices you identified in the spreadsheet provided to us on May 7, 2024. Also, in this spreadsheet, you were able to find lower internet prices for three models that were not found as part of our research in 2023. You also identified four models, which were not identified in public comment, and thus were not included in our final payment determination.”
Kaiser added that Sunrise Medical’s QUICKIE Q700 HD was removed from pricing calculations after NCART noted that the chair does not offer seat elevation, and that he and his team discovered an incorrect price was used for Permobil’s F3 HD model.
“Correcting for these two errors, the average of the commercial prices used in our payment determination is $3,094.03,” Kaiser said in the letter. “After adjusting for the annual deflation factors and the update factors, the 2024 purchase price should be increased to approximately $2,013.96.”
