Revisions to the Fee Schedule Amounts for Certain Power Mobility Devices (PMDs) are Being Made as Part of the April 2007 Quarterly 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 K0850 K0851 K0859 $4,433.20 $6,302.80 1 $5,893.70 $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 K0825 K0835 K0838 K0848 K0850 K0851 K0859 $3,997.50 $4,433.20 $4,057.40 $4,332.30 $5,284.40 $6,129.80 1 $5,893.70 $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
1
The fee for K0850 was affected by the 2006 and 2007 adjustments.
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 2007 fee schedule amounts resulted from adjustments to reflect recent policy changes related to angle adjustable footplates. These are now separately billable for certain PMDs based upon clarification issued by the Program Safeguard Contractors in a policy article which can be accessed at the following site: http://www.palmettogba.com/palmetto/Providers.nsf/44197232fa8516898525719600693 9dd/85256d580043e7548525726d00665246?OpenDocument These provisions will be incorporated in a future revision of the Power Mobility Devices and Wheelchair Options and Accessories Policy Articles. For specific coding questions please contact the SADMERC at www.palmettogba.com/SADMERC or by calling 1877-735-1326
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