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DME MACs to Allow More Flexibility for MWC Home Assessments
Starting in July, “indirect” home assessments will be allowed for Medicare manual wheelchair claims.

June 26, 2024 by Laurie Watanabe

The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have revised their home assessment requirement for manual wheelchairs provided to Medicare beneficiaries.

Starting July 1, 2024, the DME MACs will allow home assessments to be “indirectly” obtained by the supplier who is providing the manual wheelchair.

The DME MACs plan to remove the following from the current policy: “When the home assessment is based upon indirectly obtained information, the supplier must, at the time of delivery, verify that the item delivered meets the requirements specified in criterion C.”

Additionally, the sentence “Issues such as the physical layout of the home, surfaces to be traversed, and obstacles must be addressed by and documented in the home assessment” has been changed. The updated section now reads, “Regardless of the method used for the home assessment, issues such as the physical layout of the home, surfaces to be traversed, and obstacles to the use of the selected manual wheelchair must be addressed by and documented in the home assessment.”

In a June 18 bulletin, the American Association for Homecare (AAHomecare) said the change “will benefit both suppliers and beneficiaries” by making the home assessment process more efficient.

The DME MACs previously required an in-person home assessment for beneficiaries seeking manual wheelchairs from Medicare. However, “The industry was able to work with the DME MACs and CMS [Centers for Medicare & Medicaid Services] during the PHE [public health emergency] to allow only indirect assessments,” AAHomecare said. “Recent publications were unclear on whether an indirect was allowed, followed by an in-person.

“This update allows for indirect assessments, such as a phone call, easing the burden on suppliers and improving access for beneficiaries in remote areas. The indirect assessment documentation must clearly detail the beneficiary’s home layout, surfaces, and any obstacles that might impact wheelchair use.”

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