01-03-2007
THE ALLOWABLES HAVE BEEN SET FOR THE EQUIPMENT; HOW DOES A REHAB PROVIDER GET PAID FOR THE SERVICES REQUIRED TO PROVIDE THAT PRODUCT?
Theoretically, the allowables for power mobility devices have the service factor included into the price of the equipment, as the service factor is not currently broken out. As an industry the next step would to get these services broken out and coded. Providers are professionals that have been trained, are on call, and are depended on when an end user is venerable, much like professionals offer a service such as firefighters or policemen. They may show up at your door at anytime when their expertise is called upon.
DOES CMS TO APPRECIATE WHAT IS REQUIRED TO PROVIDE REHAB? IF NOT, HOW DO WE GET CMS TO APPRECIATE OUR EFFORTS?
I believe they are evolving just like we are as an industry. For example, the grouping of the codes and the LCD language attempts to address the difference from consumer power and complex rehab. There have been many revisions to the power wheelchair codes, local coverage determination, and fee schedule over the past two years in order to get it right. The revisions are proof of their efforts not to “stay the course” and to try and listen and understand what the industry is relaying, and to understand that the process of providing rehab equipment is not as simple and easy as it was in the 60’s.
DO YOU AS A MANUFACTURER NOTICE MORE DEALERS USING YOU TO HELP WITH CODING?
Sure. It is difficult to keep up with an industry changing at such a fast pace concerning accreditation, certification, coding, competitive bidding, changing LCD’s, and reimbursement. And that is just Medicare, not to mention other funding sources such as Medicaid and private insurance. As a manufacturer, we must be a resource, and Permobil understands the importance of working with dealers to ensure the funding of our product. The manufacturer knows their products best so we have committed resources to assist our dealer network to help keep their head above water.