PMD Fee Schedule Changes
March 23, 2007

Revisions to the power mobility device (PMD) fee schedule were released Friday, March 23rd by CMS. The revisions, attached below, will be incorporated into the April quarterly fee schedule update.

2006 Fee Schedule Changes

Effective for claims with dates of service November 15, 2006 though December 31, 2006, the 2006 fee schedule amounts have been revised for HCPCS codes K0825, K0850, K0851 and K0859. The revised 2006 fee schedule ceiling amounts for purchase of new PMDs classified under these codes are:

K0825 $4,433.20

K0850 $6,302.80*

K0851 $5,893.70

K0859 $6,711.70

Beginning April 2, 2007, suppliers may submit previously processed claims for these items with dates of service November 15, 2006 though December 31, 2006, to the DME MACs or DMERCs for adjustment. These claims may only be submitted on or after April 2, 2007, in order to allow carrier system updates to occur.

The changes in the 2006 fee schedule amounts resulted from corrections to manufacturer suggested retail prices that were used in establishing the fee schedule amount and removal of payment for angle adjustable footplates, accessories that cannot be used on certain types of PMDs.

2007 Fee Schedule Changes

Effective for claims with dates of service on or after January 1, 2007, the 2007 fee schedule amounts have been revised for HCPCS codes K0822, K0825, K0835, K0838, K0848, K0850, K0851 and K0859. The revised 2007 fee schedule ceiling amounts for purchase of new PMDs classified under these codes are:

K0822 $3,997.50

K0825 $4,433.20

K0835 $4,057.40

K0838 $4,332.30

K0848 $5,284.40

K0850 $6,129.80*

K0851 $5,893.70

K0859 $6,711.70

Beginning April 2, 2007, suppliers may submit previously processed claims for these items with dates of service on or after January 1, 2007, to the DME MACs or DMERCs

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*The fee for K0850 was affected by the 2006 and 2007 adjustments.

Click here to access the revisions.