A new proposed rule from the Centers for Medicare & Medicaid Services (CMS) includes December 2019 legislation regarding Complex Rehab Technology (CRT) manual wheelchairs and accessories.
That legislation exempted CRT manual wheelchairs and accessories from Medicare’s controversial competitive bidding program.
The proposed rule also provides details on an 18-month suspension of using competitive bidding-derived pricing to determine payment rates for CRT manual wheelchair accessories. That moratorium expires June 30, 2021.
CMS released the proposed rule on Oct. 27. In a bulletin to CRT stakeholders on Oct. 28, NCART Executive Director Don Clayback said, “While it is good to see these items officially included in the CMS proposed rule, we need to continue to push CMS to ‘make permanent’ the temporary CRT manual wheelchair accessory policy.”
Clayback added that the proposed rule also suggests changes to make HCPCS coding applications, reviews and modifications “easier and more transparent,” and suggests a new process of public consultation for benefit category determinations and payment determinations for Medicare Part B items, including new durable medical equipment (DME), prosthetics and orthotics.
“NCART will be conducting a more in-depth review and carrying out further analysis before submitting formal comments on these proposals by the late-December due date,” Clayback said.
On the DME front, CMS also announced that its Medicare competitive bidding program would award contracts — valid starting Jan. 1, 2021 — in only two competitively bid categories: off-the-shelf back braces and off-the-shelf knee braces. “They will not be moving forward with implementing competitive bidding in 13 of 15 product categories,” Clayback said in his bulletin. “We expect that CMS will be issuing further details.”
