The Medicare telehealth flexibility granted to physical and occupational therapists since the start of the COVID-19 pandemic is about to expire, again. But newly introduced bills seek a two-year extension. After multiple telehealth extensions throughout the pandemic’s public health emergency (PHE), the current waiver is due to end on Sept. 30, unless Congress takes action.…
Legislation Introduced as Sept. 30 Telehealth Deadline Looms for Clinicians
Briefly: DME MACs Issue October HCPCS Changes; RESNA Pop-Up Certification Event Is Sept. 18
Featuring CGS Administrators, the Rehabilitation Engineering & Assistive Technology Society of North America, and The Ohio State University.
DME MACs List October HCPCS Code Changes The DME MAC contractors have released the list of HCPCS code changes going into effect on Oct. 1. In a Sept. 9 notice, CGS Administrators, the Jurisdictions B and C DME MAC, released code changes in the seating and mobility segment: — E0150: Combination wheeled walker with seat…
August 2025: The Complexities of Wheelchair Repair
All seating and wheeled mobility stakeholders agree that repairing Complex Rehab Technology (CRT) wheelchairs often takes far too long. But many stakeholders — consumers, caregivers, clinicians, providers, manufacturers, funding sources, policy makers — disagree on what’s at the root of the problem … making it challenging to agree on a way forward. In this digital…
AAHomecare: Proposed Rule’s Competitive Bidding Plan an ‘Asteroid’ Heading for DME Industry
CMS is taking public comments on its proposed Medicare competitive bidding process till Aug. 29.
The home health proposed rule’s plans for the resumption of Medicare competitive bidding for durable medical equipment (DME) is an “asteroid” whose impact would be devastating for home medical equipment (HME) providers and the patients they support. Tom Ryan, the CEO/president for the American Association for Homecare (AAHomecare), made that comment during an Aug. 6…
2026 Proposed Rule: CMS Recommends Annual DMEPOS Accreditation, Prior Authorization Changes
The changes were listed in the proposed rule for the calendar year 2026 home health prospective payment system.
The Centers for Medicare & Medicaid Services (CMS) wants Medicare durable medical equipment (DME) providers to be re-accredited annually, and also wants to change the prior authorization process for suppliers billing Medicare. The proposed changes were listed in the Calendar Year 2026 Home Health Prospective Payment System Proposed Rule Fact Sheet, CMS-1828-P, released June 30.…
Insurers Pledge to Streamline Prior Authorization, Ease Provider Burden: What CRT Should Know
AHIP says it is committed to improving the prior authorization process across commercial insurance.
The practices of the nation’s commercial insurance giants – tactics that have included stringent prior-authorization requirements – have increasingly come under scrutiny. In turn, members of Congress and federal health care regulators have called for drastic reform. Those calls for action are now starting to see progress, which could mean a more streamlined reimbursement landscape…
NCART Provides HCPCS Update for Wheelchair Securement Systems, Vehicle Components
The effective date of service for E1022 and E1023 was April 1.
Following DME MAC and Pricing, Data Analysis, and Coding (PDAC) bulletins on May 22, the National Coalition for Assistive & Rehab Technology (NCART) issued a reminder on June 3 on coding for wheelchair transportation securement systems, components, and accessories, along with a warning about coding for securement systems mounted on motor vehicles. The NCART update…
New CMMI Paper Lists Three ‘Strategic Pillars’ to Guide Medicare, Medicaid Strategies
Center for Medicare and Medicaid Innovation Director Abe Sutton published the paper on May 13.
The Center for Medicare and Medicaid Innovation (CMMI/Innovation Center) has revealed three pillars that will guide Medicare and Medicaid strategies as part of President Donald Trump’s “Make America Healthy Again” (MAHA) mandate. Abe Sutton, CMMI director and deputy administrator for the Centers for Medicare & Medicaid Services (CMS), authored the paper, “CMS Innovation Center Strategy…
United Spinal Reacts to Proposed Medicaid Cuts, Urges Stakeholders to Act
The Congressional Budget Office said the so-called “one big, beautiful bill” would cut $715 billion from Medicaid over the next 10 years.
United Spinal Association is urging stakeholders to act swiftly to prevent sweeping Medicaid cuts that are part of the Trump administration’s so-called “one big, beautiful bill” that advanced out of the budget committee on Sunday night, May 18, according to a report from PBS. The association said in a May 16 bulletin that the bill…
Seat Elevation: Why a Heavy-Duty Code Matters
Understanding the physics of seat elevation and how it compares to other seating functions.
It’s all about access, engineering … and physics. The spring 2024 coding and funding decision by the Centers for Medicare & Medicaid Services (CMS) for power seat elevation was a textbook case of good news and bad news. The good news: CMS, citing how seat elevation can support and facilitate transfers and reaching tasks, affirmed…