CMS Revises PMD Fee Schedule Again

BALTIMORE–CMS revised its power mobility device fee schedule
yet again last week, raising reimbursements for most codes.

The agency said its revision, announced late Tuesday, would
correct “technical errors made in the calculation of base fee
schedule amounts” to make sure the payment rates are accurate. The
fees were originally issued Oct. 2, then revised Nov. 11 before the
fee schedule took effect Nov. 15.

The biggest increase was to code K0840, which rose by $1,147.
All other PMD codes also were increased with a few exceptions:
K0830 and K0831 dropped by $511.80; K0841 and K0842 were reduced
$232.90; and K0859 decreased by $552.50.

But the extensively prescribed Group 2 K0823 was bumped by only
$75.20, and K0825 by only $277.60.

Industry stakeholders said they welcome the increases, but that
they still aren’t high enough.

Regarding the K0823, The Scooter Store, New Braunfels, Texas,
issued a statement Thursday that said “while the $75 increase in
reimbursement … is appreciated, we firmly stand behind the
supporting data that the industry presented to CMS four weeks ago
that substantiated an increase of $428.”

Last week, the company announced that it was laying off 200
employees, citing Medicare’s PMD reimbursement cuts (see HomeCare Monday, Dec.4).

Seth Johnson, chairman of the American Association for
Homecare’s Rehab Council and vice president of government affairs
for Pride Mobility, Exeter, Pa., said he is waiting to see how CMS
put its fees together. “We really need to see the details of those
calculations to determine how they arrived at these payment amounts
and whether they are accurate,” he said, adding that the agency is
expected to release that information sometime this week.

CMS said the new fees are effective for claims with dates of
service on or after Nov. 15, and that providers can resubmit
previously paid claims for adjustment. AAHomecare said it should
also be noted that the fee amounts do not include batteries, which
are separately billable.

To view the revised PMD prices, click here.