Medicare Issues Revised Local Coverage Determinations (LCD)

for Power Mobility Devices – Implementation Date of New Codes and LCD delayed until November 15, 2006 –

As a result of significant industry efforts to obtain modifications to the Local Coverage Determination (LCD) for Power Mobility Devices (PMDs) that was released on August 15, 2006, the Medicare Durable Medical Equipment Program Safeguard Contractors (PSCs) have announced they have revised the LCD for PMDs, and extended the implementation date of the LCD to November 15, 2006. In addition, the Centers for Medicare and Medicaid Services (CMS) have also announced on their web site the delay of the new codes and LCD until November 15, 2006 and indicated the fee schedules for the new PMD codes “should be available in the near future.”

The following link will take you to the Region A/B DME PSC web site bulletin on the LCD revision and delayed implementation date:

Power Mobility Devices – Delayed Implementation and Policy Revision

The CMS announcement on the revision of the LCD and delayed implementation of the new codes can be found at:

New Codes, Fee Schedule Amounts and Local Coverage Determinations (LCDs) for Power Mobility Devices

One highlight of the revised LCD is the elimination of the automatic “downcoding” to Group I power wheelchairs if the patient did not meet coverage for a Group II or higher chair. Per the announcement from the Region A/B PSC: “With this in mind, one of the changes that has been made in the policy is to eliminate the least costly alternative determination that would have downcoded Group 2 to Group 1 power wheelchairs.”

U.S. Rehab will provide further details on these revisions and proposed fee schedules as they become available. If you have any questions on this information, please contact U.S. Rehab at 800-987-7342.