CMS Eliminates Specialist Requirement to Prescribe Scooters, POVs

BALTIMORE–Any physician can now prescribe a scooter or power
mobility vehicle under Medicare, according to a policy revision
posted by the DMERCs. Effective retroactively for dates of service
on or after May 5–when CMS’ new National Coverage Determination
for mobility took effect–the policy eliminates the restriction
that required a specialist in physical medicine, orthopedic
surgery, neurology or rheumatology to prescribe such equipment.

Because Medicare’s new mobility coverage policy takes physicians
and clinicians through a “stepped” approach for prescribing the
most appropriate equipment–from canes, walkers and manual
wheelchairs to scooters and power wheelchairs–some in the industry
are predicting that the change will quickly boost scooter
sales.

“By eliminating these restrictions that artificially kept people
out of scooters, scooters are going to become consumer power
again,” said DuWayne Kramer, president of Kansas City, Kan.-based
Leisure Lift.

When Medicare tightened restrictions on scooters, he explained,
it caused an increase in the use of power wheelchairs because they
were usually easier for patients to obtain, even though the
equipment was more expensive. “A lot of people that could have been
in a scooter were in power wheelchairs,” Kramer said. Now, he said,
“If I can turn a tiller, then I’m going to get a scooter before I
get a power chair, which … is the way it should have been all
along.”

According to Seth Johnson, director of government affairs for
Pride Mobility, Exeter, Pa., the policy revision is welcome. “We
believe it’s a positive step forward,” Johnson said. “It’s going to
broaden the policy for those individuals who qualify for a scooter
to obtain one.”

“Now,” Johnson continued, “we’re just waiting on the
face-to-face [physician exam] and new [certificate of medical
necessity]” as forthcoming regulations that will continue CMS’
mobility benefit overhaul. He also said the industry is still
waiting on documentation guidance for claims reimbursement.
“Hopefully when all the regulations are put into place, suppliers
will have a clear picture as to requirements that are needed to
prove medical necessity has been met.”

The DMERCs have posted instructions for completing the current
POV/scooter CMN to comply with the new scooter policy. For more
information on CMS’ mobility NCD, DMERC Region D has posted
frequently asked questions, available
by clicking here.