AOTA Protects OT Role in Power Mobility Device Evaluations
At AOTA's urging, the Centers for Medicare & Medicaid Services' (CMS') durable medical equipment regional carriers (DMERCs) have instructed physicians that they can refer patients to an OT to perform part of the face-to-face evaluation required for power mobility devices (PMDs). OTs should use the newly revised CPT code 97542 to bill for the wheelchair assessment, fitting, and training. This clarification will help secure OT referrals!
In previous draft policy communications from CMS and the DMERCs on power mobility devices, the Medicare agency and its contractors failed to state that an occupational therapy evaluation of a beneficiary's need for a PMD would be considered proof of medical necessity. AOTA voiced its concerns to CMS and the DMERCs that such an omission could result in beneficiaries lacking access to occupational therapy evaluations due to physicians wrongly believing that these assessments were not medically necessary. The DMERCs agreed that the occupational therapy wheelchair assessment is an integral component of power mobility evaluations and issued this strong clarification to physicians in a recent letter. To read the contractors' letters to physicians select the appropriate Web site:
Region A: See Physician Letter
Region B: See Physician Letter
Region C: See Physician Letter
Region D: See Physician Letter