CMS: New rates will be in place July 1

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Tuesday, March 3, 2020

WASHINGTON – CMS has provided an update on billing for accessories for complex rehab manual wheelchairs, according to NCART.

A bill was passed late last year requiring the agency to stop applying competitive bidding pricing to these accessories for 18 months starting Jan. 1, 2020.

NCART pulled these highlights from the update:

  • The new payment rates (not yet published) will be in place on July 1 and providers will be able to use the KU modifier for billing. Until July 1, providers should continue to bill as they have been.
     
  • These codes have been added to the list of impacted complex wheelchair base codes: E1231, E1232, E1233, E1234.
     
  • Public comments regarding impacted accessory codes are being requested by March 12. NCART plans to review the codes to ensure all needed codes have been included and will submit comments.
     
  • CMS is researching whether or not they will be able to offer the option to automatically reprocess claims submitted prior to July 1, rather than requiring providers to resubmit.