The National Institutes of Health (NIH) and the Centers for Medicare & Medicaid Services (CMS) are partnering on a “real-world data platform enabling advanced research across claims data, electronic medical records, and consumer wearables,” the Department of Health & Human Services (HHS) said in a May 7 press release. “We’re using this partnership to uncover…
New NIH, CMS Partnership Aims to Build ‘Data Platform’ for Research on Chronic Conditions
HHS Starts ‘Transformation’ that will Reorganize CMS, Other Health-Care Agencies
Programs supporting seniors, people with disabilities will be integrated into other agencies.
With sweeping changes that include reorganizing the Centers for Medicare & Medicaid Services (CMS), the U.S. Department of Health & Human Services (HHS) has begun the “transformation” mandated by an executive order from President Donald Trump. On March 27, HHS announced that changes — which will involve the Centers for Disease Control (CDC) and the…
CMS Issues HCPCS Code Updates Effective April 1
The Centers for Medicare & Medicaid Services' second biannual 2024 HCPCS coding cycle included changes to hardware codes.
The Centers for Medicare & Medicaid Services (CMS) has released lists of HCPCS coding changes effective April 1, 2025. The list, published March 11, includes updates on codes and modifiers that are new, revised or discontinued for the second biannual 2024 HCPCS coding cycle. Wheelchair transit accessories: Two new codes CMS reported that Palmetto GBA,…
CMS Classifies TAI as Prosthetic Devices, Updates Funding Policy
The change could help wheelchair riders with neurogenic bowel symptoms.
A new Centers for Medicare & Medicaid Services (CMS) policy change has opened the door to reimbursement for transanal irrigation devices (TAI), catheters and accessories. United Spinal Association reported on Feb. 13 that CMS published a positive Benefit Category Determination for TAI, catheters and accessories on Jan. 13. United Spinal said CMS now considers this…
Noridian SMRC Announces Post-Payment Review of 2022-2023 Catheter Claims
The review involves HCPCS codes A4351, A4352 and A4353.
Noridian Healthcare Solutions, the Supplemental Medical Review Contractor (SMRC) for the Centers for Medicare & Medicaid Services (CMS), is conducting post-payment reviews of Medicare DME claims for intermittent urinary catheters with dates of service from Jan. 1, 2022, through Dec. 31, 2023. In its announcement, Noridian referenced a February Washington Post story, “US Investigates Alleged…
CMS Wants to Prevent ‘Barriers to Care’ in Medicare Advantage Programs, Add Guardrails Around AI
The Centers for Medicare & Medicaid Services announced policy changes last week.
The Centers for Medicare & Medicaid Services (CMS) is looking to further crack down on the companies that administer the privatized version of Medicare. On Nov. 26, CMS proposed new policies aimed at holding Medicare Advantage (MA) plans more accountable while removing “unnecessary barriers to care” for Medicare beneficiaries. The policies target “inappropriate” prior authorization…
Nov. 6 HCPCS Public Meeting to Include Discussion on CRT Seat Elevation, Joystick Hardware
NCART and Palmetto GBA have asked the Centers for Medicare & Medicaid Services to make coding changes.
The Nov. 6-8 second biannual HCPCS public meeting includes a request to revise the Medicare reimbursement for HCPCS code E2298, defined as Complex rehabilitative power wheelchair accessory, power seat elevation system, any type.” The applicant — the National Coalition for Assistive & Rehab Technology (NCART) — is recommending that language be changed to “Complex Rehabilitative…
Commentary: CRT As Prevention? What a Concept!
A new report published by VGM & Associates suggests Medicare competitive bidding has run its course.
A new report, authored by Brian Leitten of Leitten Consulting and published by VGM & Associates, contends that the Centers for Medicare & Medicaid Services (CMS) has taken the wrong perspective of durable medical equipment (DME) for at least for the last two decades. The 2003 Medicare Prescription Drug, Improvement, and Modernization Act gave rise…
CMS Raises CRT Seat Elevation Medicare Allowable by $13.62
Joel Kaiser, director of the division of DMEPOS policy, responded to NCART’s recalculation request.
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…
ReWalk Robotics Lauds Medicare Allowable for Personal Exoskeletons
The final payment rate affects claims with dates of service on or after April 1.
ReWalk Robotics Ltd. (DBA: Lifeward) is lauding the Centers for Medicare & Medicaid Services’ (CMS) decision to provide Medicare coverage for personal exoskeletons. In an April 12 announcement, ReWalk — which manufactures the ReWalk personal exoskeleton and the ReStore Exo-Suit, among other rehabilitation products — said, “The Centers for Medicare & Medicaid Services has officially…