CMS Shares Implementation Details on New CRT Accessories Policies

Among various, still-coming details, agency says claims processing system won’t be updated to properly process changes until at least July 1.

CMS has released some additional details regarding its implementation of the protections for manual CRT chairs and accessories that were part of the Further Consolidated Appropriations Act, which was passed by Congress and signed into law at the end of 2019.

Those provisions came from the Protecting Access to Wheelchairs Act and permanently exempt manual CRT wheelchairs from the competitive bid program. They also suspend the application of competitive bidding-derived reimbursement rates for manual CRT wheelchair accessories for 18 months, starting Jan. 1, 2020. The provisions cover wheelchair HCPCS codes E1161, E1235, E1236, E1237, E1238, K0005, and K0008, and accessories and seat back cushions falling accompanying those codes.

The major news: CMS stated in a public update that it likely would not complete the necessary changes to the Medicare claims processing system until at least July 1.

“Until these changes are implemented, payment for these items will be based on the adjusted fee schedule amounts,” the statement read. “Suppliers should continue to submit claims for these items with dates of service on or after Jan. 1, but payment will be based on the adjusted fee schedule amounts in the interim. After the changes to the claims processing system can be implemented, payment at the full fee schedule amounts for claims submitted for these items with dates of service on or after Jan. 1, will be available retroactively.”

CMS added that, in the coming months, it would provide additional information, including a list of HCPCS codes for accessories affected by the change and further instructions on submitting and processing of these claims.

The American Association for Homecare reported that In its correspondence with CMS, the agency acknowledged that much work remains to implement the relief, that the association would continue to work with CMS on ensuring relief for suppliers. It added that the implementation of this relief is similar to its previous work with providing retroactive payments with the CURES relief in 2016.

About the Author

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


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