CMS Changes Power Mobility Codes, Testing Requirements

Baltimore

In February, CMS unveiled a plan to implement 49 new power wheelchair and scooter codes — scheduled to take effect Jan. 1 — that break down the broad K0011 code to specific configurations. But last month, the agency upped that number to 63, announcing that the billing codes and product testing standards need even more revisions to differentiate among some types of equipment. The first-of-the-year implementation date, however, remains.

Originally set for Sept. 1, the product testing deadline has been extended to Nov. 15 to allow power mobility manufacturers more time to conduct tests under the revised standards.

If products have already been tested and the results have been submitted to the statistical analysis durable medical equipment regional carrier, “every effort” will be made to determine the proper code placement, according to CMS. But for products currently undergoing testing, or for those that are untested, manufacturers must test according to the new guidelines.

Other changes to the code sets and testing requirements announced by CMS and the SADMERC include:

• Adding a new “standard use” category for power mobility devices.
• Revising the characteristics of the previous categories of PMDs.
• Revising the testing requirements for all categories of power mobility devices to be consistent with current Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) standards.
• Establishing a reliable testing strategy that will allow CMS and the SADMERC to consistently assign power wheelchairs to specific codes.
• Revising testing requirements so that CMS and the SADMERC are able to differentiate among the various levels of equipment in terms of durability and level of performance.