PMD Fee Schedule Revised Again; Most Codes See Raises

Baltimore

CMS revised its power mobility device fee schedule again in mid-December, raising reimbursements for most codes.

The agency said its latest revision 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, 2006, 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 pointed out that for some categories, the new fees still represent cuts of 10 to 30 percent.

Regarding the K0823, The Scooter Store, New Braunfels, Texas, issued a statement that said “while the $75 increase in reimbursement … is appreciated, we firmly stand behind the supporting data that the industry presented to CMS” that substantiated an increase of $428. (See “Scooter Store Lays Off 200.”)

Seth Johnson, chairman of the American Association for Homecare’s Rehab Council and vice president of government affairs for Pride Mobility, Exeter, Pa., said at press time he was waiting on information from CMS to see how the agency put its new 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.

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.