Manufacturers Say PMD Product Classification List Is Inaccurate

BALTIMORE–Stakeholders said a new power mobility product
classification list released by the SADMERC last week is riddled
with errors, but they are hopeful that corrections will be made
before prices are calculated.

The release of the list is the latest step in preparing to
implement 64 new Medicare power mobility codes that are scheduled
to take effect Oct. 1 (see HomeCare Monday, June 5). The product
classification list, which contains each HCPCS code assignment for
power wheelchairs and scooters, classifies products according to
performance data and device feature information supplied by the
industry’s power mobility manufacturers.

A good number of the products submitted by Invacare Corp. were
misclassified, according to Cara Bachenheimer, vice president,
government relations, for the Elyria, Ohio-based manufacturer. “We
were disappointed to see a number of our products are miscoded. But
we’re optimistic that the SADMERC is going to look at data and
correct mistakes,” she said, adding that the SADMERC indicated it
would release a revised list this week.

Seth Johnson, vice president, government affairs, for Exeter,
Pa.-based Pride Mobility Products, also remains positive. “We have
some significant concerns, and changes need to be made before they
calculate the new fee schedules,” he said. “We are very hopeful
that the SADMERC is going to work with us to address the problems
and issue a new, accurate product classification list before the
fee schedule is released.”

Fee schedules for the new codes are expected to be published as
part of the October 2006 DMEPOS update. Following the SADMERC’s
product classification list, CMS published a document containing
information it has gathered to establish fee amounts for the new
HCPCS codes. This document includes both the median wholesale and
suggested retail prices reported by manufacturers for products
under each code.

In addition to manufacturers’ suggested prices, the agency said
it also had obtained actual retail prices from “several reputable
Internet sites that specialize in furnishing power wheelchairs and
are widely used by Medicare beneficiaries and other consumers.” In
an explanation accompanying the pricing source list, CMS said,
“Determining pricing sources that best reflect pricing on a free
and open market ensures efficient pricing and better access to
current technology.”

CMS said it is “very interested” in receiving comments on the
document and suggestions on how to obtain more information on
actual retail prices.

But because the pricing source list is based on the product
classification list, mobility stakeholders noted, this document
also is incorrect and needs to be reissued.

However, this shouldn’t stop people from commenting, Johnson
said. “It’s still necessary for providers and stakeholders to
provide comments on why some of these categories are not
appropriate to be considered when you’re talking about calculating
Medicare fee schedule amounts.”

To view the product classification list, click here. To download the pricing source
document, click here.

Comments on the pricing sources can be submitted via e-mail to
[email protected] by
Aug. 25.