BALTIMORE--The long-awaited final rule on documentation and payment procedures for Medicare power mobility devices is scheduled to be published this Wednesday, CMS announced.

In a fact sheet issued Friday evening, CMS said one major change in the final rule is that it gives physicians and treating practitioners 45 days, rather than 30 days, after the date of a face-to-face patient examination to supply medical records to HME providers. Industry stakeholders had been pushing for a 60-day timeframe.

In August, CMS released an interim final rule on power mobility devices (see HomeCare Monday, Aug. 29, 2005) that eliminated the power mobility certificate of medical necessity and replaced it with a doctor's prescription and a face-to-face exam. The rule also requires doctors to supply providers with patient records documenting medical necessity. The IFR originally took effect Oct. 25, but an HME industry effort, including the Restore Access to Mobility Partnership, with members Pride Mobility, Invacare Corp. and the American Association for Homecare, succeeded in delaying the rule until at least April 1.

Since the release of the IFR, stakeholders have been anxiously seeking further instructions on exactly what documentation should be included with reimbursement claims.

According to CMS, the final rule "gives physicians, other treating practitioners and suppliers greater certainty regarding Medicare payment by providing more extensive guidance for how PMD claims can be supported with well-documented findings by physicians and other treating practitioners."

The new process also "eliminates the burden for physicians to provide potentially duplicative information on multiple forms," the agency said.

The pertinent parts of the medical record should include documentation of the face-to-face exam, including information such as the history, physical examination, diagnostic tests, summary of findings, diagnoses and treatment plans, CMS stated.

In an appendix titled "Documenting Medical Necessity: Pointers for Physicians and Other Treating Practitioners," CMS said the parts of the medical record selected "should be sufficient to:

--delineate the history of events that led to the request for the PMD;
--identify the mobility deficits to be corrected by the PMD;
--establish that other treatments do not obviate the need for the PMD,
--establish that the beneficiary lives in an environment that supports the use of the PMD; and
--establish that the beneficiary or caregiver is capable of operating the PMD."

Although information recorded at the face-to-face examination will be sufficient in most cases, CMS said there may be some cases where the physician has treated a patient for an extended period of time so previous notes also should be included.

On Saturday, CMS began paying physicians an add-on fee of $21.60 for the work involved in compiling and transmitting documentation to suppliers. Until now, CMS had been not been able to make these payments because funds to implement or enforce the rule were on hold.

To view the fact sheet, click here.

To view the rule after it is published in Wednesday's Federal Register, click here.