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.