HCPCS Codes Impacted by CURES Medicaid Limits Updated

AAHomecare records 244 reimbursement codes now subject to Medicaid reimbursement limits per the CURES Act.

The American Association for Homecare has compiled an updated list of the HCPCS codes that have been impacted by Medicaid reimbursement limits under the CURES Act.  

Passed in December of 2016, the CURES Act included provisions to give relief to providers and patients affected by the national expansion of competitive bidding to non-bid areas.

However, the Act also accelerated implementation of limits on the Federal matching on Medicaid reimbursement rates for HME items to the Medicare fee-for-service payment rates, including for items impacted by competitive bidding-derived rates. Rather than apply those rates in January 2019, the application would be ramped up by one year to Jan. 1, 2018. 

A total of 244 codes are subject to the CURES-related limits, according to AAHomecare, which posted a PDF file and an excel spreadsheet of the updated code list. Specfically,13 codes were removed, due to no Medicaid spending during 2017, and five codes were added, due to Medicaid expenditure during 2017.

The codes removed were:

  • E0117 - Underarm spring assist crutch
  • E0297 - Hospital Bed Total Electric w/o mattress
  • E0328 - Ped Hospital Bed
  • E0580 - Nebulizer for use w/regulator
  • E0617 - Automatic Ext defibrillator
  • E0948 - Fracture Frame Attachments
  • E1089 - Wheelchair ltwt fixed arm
  • E1090 - Wheelchair ltwt det arm
  • E1231 - Rigid Ped w/c tilt in space
  • E1405 - O2/water vapor enrich w/heat
  • E1406 - O2/water vapor enrich w/o heat
  • K0854 - PWC Grp 3 xhd seat/back
  • K0855 - PWC Grp 3 xhd cap chair

The codes added were:

  • E0170 - Commode chair electric
  • E0300 - Enclosed ped crib hosp grade
  • K0554 - Ther CGM receiver/monitor
  • K0807 - POV group 2 hd 301-450 lbs
  • K0808 - POV group 2 vhd 451-600 lbs 

About the Author

David Kopf is the Executive Editor of HME Business and DME Pharmacy magazine. Follow him on Twitter at @postacutenews.



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