CMS Has Removed The April 1, 2008 “ATP” Requirement

In a letter from The DME PSC medical directors to the AOTA – copy courtesy of Mark Schmeler from the University of Pittsburgh: CMS has removed the April 1, 2008 ATP requirement for the specialty evaluation of complex rehab. As you will read, the “ATS” supplier requirement stays in effect.

December 3, 2007

Sharmila Sandhu, Esq.
The American Occupational Therapy Association, Inc.
4720 Montgomery Lane
Bethesda, MD 20814-3425

Dear Ms. Sandhu,

The DME PSC medical directors have decided to accept your request to revise the Power Mobility Devices LCD and eliminate the requirement that patients receiving rehab power wheelchairs on or after April 1, 2008 be evaluated by a RESNA-certified Assistive Technology Practitioner. The current requirement will remain in place – i.e., the patient must have "a specialty evaluation that was performed by a licensed/certified medical professional, such as a PT or OT, or physician who has specific training and experience in rehabilitation wheelchair evaluations and that documents the medical necessity for the wheelchair and its special features". In addition, for claims with dates of service on or after April 1, 2008, we will implement the requirement that the wheelchair must be provided by a supplier that employs a RESNA-certified Assistive Technology Supplier (ATS) or Assistive Technology Practitioner (ATP) who specializes in wheelchairs and who has direct, in-person involvement in the wheelchair selection for the patient.

The DME MACs and PSCs will publish an article later this week that notifies suppliers of this decision. This information will also be incorporated in a future revision of the Power Mobility Devices LCD.

We thank you for your participation in the LCD Reconsideration process.

Sincerely,

Paul J. Hughes, M.D.
Medical Director, DME PSC Jurisdictions A&B

Mark D. Pilley, M.D.
Medical Director, DME PSC Jurisdiction D

Adrian M. Oleck, M.D.
Medical Director, DME PSC Jurisdiction C