BALTIMORE--CMS continues to revise its PMD fee schedule, upping reimbursements for some Group 3 power wheelchairs, among other changes.

The agency bumped reimbursements for codes K0857 and KO859, which it said had been incorrectly posted. The fee for K0857 rose by nearly $500 to $5,673. Reimbursement for code KO859 rose more than $600 to $7,091. Another change will allow separate billing for expandable controllers on chairs in Groups 3, 4 and 5.

In an e-mail sent Tuesday to some industry representatives, CMS said the correct prices for the K0857 and KO859 chairs would be posted on the agency's Web site as soon as possible.

The e-mail also said articles will be posted on CMS contractor Web sites clarifying that suppliers can bill separately for expandable controllers furnished with Group 3 (codes K0861 through K0864), Group 4 (codes K0884 through K0886) and Group 5 (K0891) multiple power option wheelchairs.

The code to be used for expandable controllers furnished with these wheelchairs will be K0108 for claims with dates of service from Oct. 1, 2006, through Dec. 31, 2006, and E2377 for claims with dates of service on or after Jan. 1, 2007, CMS said.

The changes will be retroactive to Nov. 15, when the fee schedule officially took effect.

Stakeholders said the revisions resulted from industry feedback, as was the case in the agency's decision last week to increase payments for some Group 2 and Group 3 power wheelchairs (see HomeCare Monday, Nov. 13).

On Thursday, Pride Mobility officials met with HHS Secretary Mike Leavitt, Acting CMS Deputy Administrator Herb Kuhn and Sens. Arlen Specter and Rick Santorum to discuss the fee schedule. In addition to the latest revisions, Pride said CMS is considering an adjustment to the K0823 code (Group 2 Standard, Captain's Chair), since gap-fill data CMS used to set the fee may not have been accurate.

CMS also is considering correcting allowables for code K0825 (Group 2 Heavy Duty, Captain's Chairs). According to Pride, "CMS clearly recognized that there are additional costs for manufacturing heavy duty power wheelchairs above those for standard power wheelchairs."

In a string of statements released last week, the power mobility sector's major manufacturers, providers and patient advocate groups applauded CMS' willingness to work with the industry on refinements to the fee schedule.

According to Portland, Maine-based Black Bear Medical President Jim Greatorex, who is also a board member of the National Coalition for Assistive and Rehab Technology, "I wouldn't say that we're living in a perfect reimbursement arena now--and there still are cuts involved with the fee schedule--but we certainly have left the brink of complete disaster."

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