Accessories: Updated payments take effect, will be applied retroactively

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Thursday, January 16, 2020

WASHINGTON – Updated payment rates for complex manual wheelchair accessories went into effect Jan. 1, but they may not be updated until July 1 to allow changes to be made to the claims processing system, according to a bulletin from CMS. As such, suppliers should continue to submit claims for these items with dates of service on or after Jan. 1, 2020, but payment rates will continue to be based on the adjusted fee schedule amounts in the interim. After changes to the system are implemented, payment rates at the full fee schedule amounts for claims with dates of service on or after Jan. 1, 2020, will be available retroactively. In December, both the House of Representatives and the Senate passed H.R. 1865, a year-end spending bill that includes language requiring CMS to stop applying bid pricing to these accessories for 18 months starting Jan. 1, 2020.