Since CMS introduced 64 new power mobility codes in June and said it would implement them Oct. 1, you've needed a scorecard to keep up with the fast-moving regulatory changes in this sector. Here's a synopsis:
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The SADMERC issued a new product classification list in August, but manufacturers complained that the list was not accurate and that many of their products had been miscoded.
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CMS then published a document containing information it had gathered to establish fee amounts for the new HCPCS codes, including both median wholesale and suggested retail prices. The agency also said it had gleaned pricing information from Internet sources.
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The Medicare Program Safeguard Contractors issued the Local Coverage Determination for power mobility devices Aug.15, including provision for a “least costly alternative” determination, or automatic down-coding. Stakeholders complained, and several members of Congress asked for a delay in implementation of the new codes and policy changes.
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On Sept. 20, the DME PSCs issued a revised LCD that eliminated automatic down-coding, and said they would delay implementation of the LCD and codes until Nov. 15.
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At press time, new PMD pricing information had not been issued. For more, see page 10.
