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NCART: Be Aware of 2017 Medicare Billing Changes

January 5, 2017 by Laurie Watanabe

NCART has advised complex rehab technology (CRT) providers of “three significant Medicare billing announcements” that will impact CRT claims and processes in the new year.

The Dec. 28 bulletin included information on billing Group 3 power wheelchair accessories; recoupment for CRT manual wheelchair accessories payment cuts during the second half of 2016; and a new prior authorization policy for two CRT power chair codes.

NCART Executive Director Don Clayback noted that the 21st Century Cures Act, which became law in December, directly impacted the current funding statuses of Group 3 power chair accessories and the opportunity for providers to recoup payments for CRT manual wheelchair accessories.

“This is very good news and should prevent an interruption in the processing of these claims as we move into 2017,” Clayback said of CRT power wheelchair accessories funding. The Cures Act extended the use of unadjusted fee schedules for those accessories through June 30, 2017.

Providers will also be able to get back “any July 1 payment cuts that were incurred for CRT manual wheelchair accessories, and other impacted DME claims such as Group 2 power wheelchairs, with dates of service from July 1, 2016, through Dec. 31, 2016,” Clayback said.

The new prior authorization policy will impact HCPCS codes K0856 and K0861, Clayback said. He added that the prior authorization process “is part of a national DME prior authorization initiative, and these first codes will be implemented in two phases.”

For more information on all three billing changes, click HERE.

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